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CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Buildir g P ermit Application (402) 426 -4191 -Phone t
(402) 426 -4195 . FAX
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WS -2014 -00583 „S@ °, q� www.blairnebraska.org
)6/2512014 MISC Residential June 25, 2014
LOCATIONOFIMPROVEMENT: 833 N 26th Ave Blair E 68008
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ARCHITECT: GENERAL Home Pride Contractors, Inc.
OWNER: Shawna A Tierney CONTRACTOR: 5202 " Q " St
�3 Omaha, NE 68117
833 N 26th Ave
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/24/2016
833N26thAve- 140625 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roofing and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/ OMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING I LANS SUBMITTED: NA
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1. No work will be started before a permit is ISSUED ANE 1 POSTED.
2. For commercial permits, a set of plans for this project i nust be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, ieating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and ac nowledges this building permit application does not constitute issuance of
this building permit. It is further understood that con truction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is iss jed.
5. The undersigned owner or agent agrees to perform tt a proposed work in accordance with the specifications set forth above and
in accordance with the codes /ordinances of the City o Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or without t e intention of the undersigned or any alteration or change from this application without approval of the
Building Official all constitute sufficient ground forte revocation of any permit issued which was based on the approval of this
applicatio %
7� N
Date
'ignature 01 Applicant