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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
. YNEW - 1 t�' i i (40 426 - 4'19'1 - Phone
B uilding Permit Applicat
yA - ����• (402) 426 -4195 - FAX
MS- 2014 -0 40 �, oU° www .blairnebraska.org
0 611 912 0 1 4
77777
MISC Residential June 19, 2014 C
LOCATIONOFIMPROVEMENT: 1752 -1762 Nebraska St, Blair, NE 58008
ARCHITECT, GENERAL Pyramid Roofing
CONMACT'OFt
OWNER: Henton P Ii, L.Ic 1604 S Saddlecreek Rd
�t ,. Omaha, NE 68106
3013092 Us Hwy
.f BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Residence 1752
PROJECT NAME PERMIT EXPIRES 06/18/2016
1752- 1762NebraskaSt- 140619 -2014 Storm 12131/2014
Damage ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roofing, siding, windows and gutters, interior work
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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 j
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 codeslordinances 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 j
Building Official, shal stitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Signature of Applicant Date
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