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CITY OFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 W Phone
(402) 426 -4195 - FAX }
WS -2014 -00582 a` °ars of a� www.blairnebraska.org
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)6/25/2014 MISC Residential June 25, 2014
LOCATIONOFIMPROVEMENT: 735 Southfork Rd, Blair NE 68008
ARCHITECT:
GENERAL Home Pride Contractors, Inc.
OWNER: Dane M And Shannon M Livermore CONTRACTOR: 5202 "Q" St
Omaha, NE 68117
735 Southfork Rd
BLAIR, NE 68008 -1897
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/2412016
735SouthforkRd- 140625 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roofing, gutters, siding and windows
DEPOSIT PAID BY: SITE PLAN UBMITTED: NA
Contractor
REScheck/C OMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING P LANS 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 n iust be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, t eating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and acl nowledges this building permit application does not constitute issuance of
this building permit. It is further understood that cons ruction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is isst ed. j
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 o Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or , w,�'thout the intention of the undersigned Dr any alteration or change from this application without approval of the
Building fcial, shall const' icient ground for t revocation of any permit issued which was based on the approval of this
appl,zat
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signature 4 App11cant Date