394.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
Building Permit Application 402 426 -4195 - FAX
" wa www.blairnebraska.org
MS- 2014 -00394 e of a�
06/17/2014 June 17, 2014
M ISC Residential
7
A LOCATIONORMPROVEMENT: 669 N 15th St, Blair, NE 68008
ARCHITECT: GENERAL Grogan Construction
4
CONTRACTOR: 3923 N 91 st St
OWNER: Mary Jo Wilson
OMAHA, NE 68134
669 N 15th St
BLAIR, NE 68008 -0000
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OF WORK PROPOSED USE
NATURE primary
Storm Repair
PERMIT EXPIRES 06/16/2016
PROJECT NAME
669N15thSt440617 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, siding, gutters, windows
DEPOSIT PAID BY:
SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMlTTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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1. No work will be started before a permit is ISSUED AND POSTED.
' I permits a set of plans for this project must be submitted to the Nebraska State Fire Ma t c st Office for review.
2. For commercia p ,
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, an sep y
4. The under g
constitute issuance of
si ned owner or agent understands and acknowledges this building permit applicatio do e/ not s
commenced until a
this building permit. It is further understood that construction covered by this permit applicatio n
copy of a permit signed by the Building Inspector is issue d
rsi ned owner or agent agrees to perform the proposed work in accordance with the m ss ificati or mesrepresentation
5. The unde g of
in accordance with the codes /ordinances of the City of BI an an alterat on change from this application without approval of the
fact with or without the intention of the undersigned or y
Official shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
Building ,
application.
to
ignature of Applican "