426.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
-4191 - Phone
Building Permit Application (402)426
(402) 426-4195 - FAX
MS-2014-00426 t www.blairnebraska.org
I IN I mom
0611912014 7 S C Residential June 19, 2014
LOCATION OF IMPROVEMENT: 519 N 16th St, Blair, NE 68008
ARCHITECT: GENERAL Blackstone Exteriors
CONTRACTOR:
OV\NER: Beth R Fegenbush 1200 HWY 92, Suite B
Winterset, IA 50273
. . . . . . . . 519 N 16th St
-0000
BLAIR, NE 68008
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06118/2016
519Nl6thSt-140619-2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roofing, siding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck1COMcheck 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 accordanc e codes/ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with o ithout th intention of the undersigned or any alteration or change from this application without approval of the
w
ng
Buildin fficial, shall c nstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app�llcati n. � 14
Signature o i Date