392.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
l i p Building Permit Application c402j 426.41s1 - Phone
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1VIS -2014 -00392 �' ^Q _ {a ° �4ozj 42s -4� �s w FAX m /so at �� www.blaimebraskal org
0619712014 J 7 51SC Residential =June 17, 2094
LOCATIONOFIMPROVEMENT: 13092 Us Hwy 30, Blair, NE 68008
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ARCHITECT: GENERAL Pyramid Roofing
n ; OWNER: Donna J And John M Co- Trustees Heaton CONTRACTOR; 1504 S Saddlecre-ek Rd
3013092 Us Hwy Omaha, NE 68106
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Storm Repair
Primary
PROJECT NAME PERMIT EXPIRES 06/1612016
13092Us Hwy 30- 140617 -2014 Storm Damage 12/3112014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Remove and replace roof, gutters, and siccing
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecktCOMeheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is issued.
5. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
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ature of Applicant (t ra to