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CITYOF BLAIR I
218 S.16TH STREET
BLAIR, NEBRASKA 68008
I,�i� 0, T -, M A {?2) 426.4191 -Phone
Building Permit Application { 4
y a' (402) 4264196 - FAX r
i'111S - 2014 -00438 rs of a� www.blairnebraska.arg
0611912014 TM ISC Residential June 19, 2014
aA l LOCATIONOFIMPRO 1752 Nebraska St Blair, NE 68008
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` ARCHiTECfi GENERAL Pyramid Roofing
CONTRACTOR OWNER Henton Property Ii, Li
CO 1504 S Saddlecreek Rd
�$ Omaha, NE 68106
30 Us Hwy
{� BLAIR, NE 68008 -0000
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NATURE OF WORK S
Storm Repair Residence 1762
PROJECT NAME PERMIT EXPIRES 06118/2016
1752- 1762NebraskaSt- 140619 -2014 Storm
Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roofing, siding, windows and gutters; interior work
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMcheck SUBMITTED: 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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Signature of Applicant Date