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CITYOFBLAIR
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218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
a �,� (402) 426 -4196 - FAX
MS -2014 -00428 � of av www.blairnebraska.org
06/19/2014 MISC Residential June 19, 2014
LOCATION OF IMPROVEMENT: 2002 Arbor Cir, Blair, NE 68008
ARCHITECT:
GENERAL C & S Roofing Inc.
OWNER: Roxane R, Etal Hall CONTRACTOR: 2211 Peoples Rd Ste B
BELLEVUE NE 68123
2002 Arbor St
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Structure
PROJECT NAME PERMIT EXPIRES 06/18/2016
2002ArborCir- 140619 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roofing, siding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck 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 o without the intention of the undersigned or any alteration or change from this application without approval of the
Building icial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applic i n. _
Sign ure of Applicant Date
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