556.tif i
CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
rm it Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS- 2014 -00556 Ise of www.blairnebraska.org
06/2512014 MISC Residential June 25, 2014
�A LOCATIONOFIMPROVEMENT: 2247 Grant St, Blair, NE 68008
ARCHITECT: GENERAL Smock Construction LLC
a
OWNER: Th omas ONTRACTOR:
omas L And Nancy J Olsen 24450 Pawnee Rd
Al R
VALLEY, NE 68064
2247 Grant St
BLAIR, NE 68008 -0000 �-
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NATURE OF WORK STRUCTURE
Storm Repair Priamry Residence
PROJECT NAME PERMIT EXPIRES 06/24/2016
2247GrantSt- 140625 -2014 Strom Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roofing and 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.
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 Offic I, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appli a
Date
Signature of Applicant