549.tif i
i
I
C
218 S. i 6TH STREET
BLAIR, NEBRASKA 68008
B uilding (402) 428 -4191 - Phone
Perm Appl ication
(402) 428 -4196 - FAX
!M5 - 2014 -0a 9 so 0 � www .blairnebraska.org I
7 06123120'14 MISC Residential June 25, 2014
F L TIONOFIMPf�OV9= 4F=NT: 1009 N 24th Av:+e, Blair, NE 68008
ARCHITEGT:
GENERAL Or Exteriors, LLC
OWNED: Donald J And Wf Lorentzen COWRAOTCrR: 661.2 N 96th at
OMAHA, NE 68134
1008 N 24th Ave
BLAIR, NE 68008-1161
X 1101
OMNI=
a e
NATURE OF WORK STRUCTURE
Storm Repair Prlarnry Residence
PROJEC NAME PERMIT EXPIRES 06 12412016
1009N dt hAve - 140 2 - 211'14 Sto Damage
ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF FORK
Rbofing, gutters, windows
DEPOSIT RAID BYA SITE PLAN SUBMITTED: :NA
Contractor
RESche+ck=Mcheck SUBMITTF -D: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1. No work will be starters before a permit is ISSUrtD 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 Iluilding 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 m of
fact with or without the intention of the undersigned or any alteration car 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.
SignatuA of Applicant Date
• I
ZO /IO 39Vd S�10I�J1]iX3 ZdG Z186SI6ZOt 60:EI t T0Z /9Z/90
i