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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
- m (402) 426 -4191 - Phone
Building Permit Application
(402) 426 -4195 - FAX j
MS- 2014 -00357 /se of ava\, www.blairnebraska.org
06/1312014 MISC Residential June 13, 2014
LOCATION OF IMPROVEMENT: 640 N 23rd St, Blair, NE 68008
ARCHITECT: GENERAL Complete Exteriors
w OWNER: Dana J And Arlene J, Trustees Wolf CONTRACTOR: 7805 L St
2038 Arbor Cir OMAHA, NE 68127
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 0611212016
640N23rdSt- 140613 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roof, some window glass, gutters
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. f
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
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Date
Signature of Applicant