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CITYOF BLAIR
218 S.16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
- Building Permit Application (402) 426 -4195 - FAX
MS- 2014 -00495 �'�� e of www.blairnebraska.org [
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06/23/2014
MISC Residential June 23, 2014
LOCATION OF IMPROVEMENT: 1139 Highland Dr, Blair, NE 68008
ARCHITECT: GENERAL Single Source Remodeling Inc.
CONTRACTOR: PO Box 12518
OWNER: Terry L Rasmussen OMAHA, NE 68112
1 �m
1139 Highland Dr
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Primary Residence
Storm Repair
PERMIT EXPIRES 06/22/2016
PROJECT NAME
11391-lighlandDr- 140623 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Reroofing, repair windows, gutters, as well as powerwasch /stain deck
DEPOSIT PAID BY:
SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
7.
1. No work will be started before a permit is ISSUED AND POSTED.
For commercial permits, a set of plans for this project must be submitted to the Nebrask onin and se t c sy t Office for review.
2.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, p m.
4. The unde g
c onstitute issuance of
rsi ned owner or agent understands and acknowledges this building permit applicatio ll not no t
be commenced until a
this building permit. It is further understood that construction covered by this permit applicatio n sha
copy of a permit signed by the Building Inspector is issue d
ersi ned owner or agent agrees to perform the proposed work in accordance with the mission
in or misrepresentation
5. The and g of
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any o royal of the
e
fact with or without the intention of the undersigned any alteration chang issued sued which was based on the approval of this
Building Official, shall c stitute sufficient ground for the revocation of any y permit
application.
Date
Signature o Applican