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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEgRASSKA 13$008
uil+ding Perm App tion (402) 426 -4101 - P hone
.. :. (402) 426 -4185 -1i FAX
MS- 2014 - 00648 ' Ire 61 ' '�` � www,blairnebraska.org
0612;5120'14 MISc Residential June 25, 2014
LOCATI OF IMPROVEMENT. 1340 Jackson St, Bla ir, NE 68008
ARC4irrEC
� GENERAL. Dr Exteriors, LL+�
OWNER Wanda R 131ankenbeckler CONTRACTOR. 6612 N 13th St
OMAHA, NE 68134 ;
1340 Jackson St
GLAIR, NE 08000 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PERMIT 06124120'10
PROJE NAME
1340JacksonSt- 140625 -2014 Strom Dainage ESTIMATED COMPLETION GATE 1213112014
DE CRIPTION OF WORK
Roofing, gu tars, siding, painting
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchdcklCLlMcheckSUBMITTELI: NA
DE POSIT STATICS: BUILDING PLANS UBMITTED: NA
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 acco r da nce with the specifications set forth above and
in accordance with the codesiordinances 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 alterati6n 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. —
Date
Sig" Aura of Applicant
30/30 39VJ SNOI�:131 EI �IQ LL86STS30t 60 :CI VT03/93/90