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401.tif Tom Kupfer 402 - 905 -2999 p.1 J u n , 1 8 . 2 0 1 4 9: 45AM CITY OF B L A I R (02. 426.4191) Ig 3831 P. 1 CIT OFSLAIR 2163.16TH -STREET SLAM, NEBRASKA 08000 j ,; - Building Permit Appli (402)+426.4191 - Phone MS-201 �a a (402) 428 4168 - rAX 'pro. of �+ www.bloilrnebraska.org 10811812014 bpelerse MiSC Residential June 18, 2014 I f 4 I.�CA 110NOFIMPROVEME~NT: 1244 S 13th Ave, Blair, NE 60000 � AR*uHfT�GT'. E F& 316 Construction Inc f5MER Cody James Olsen 'CONTf TOR 1610 N 1541h Cir� 1244 S 13th Ave BENNINGTON, NE 66007' BLA IR N E 66Qt78.000 y CH ARACTERISTICS SELECTED OF O` MATURE OF WORK PROPOSED USE Storm }repair Primary Ices idence PROJECT NAME PERMIT EXPIRES 0011 712016 1244S13thAvo- 140618-2014 Storm Damage ESTIMATED COMPLETION DATE I213112014 DESC RIPTION OF WORK Re- roof#ng with asphalt and gutters. DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA Conl ractor l: tE5checktC©MehooX SUBMITTED CIA DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA AFFADAVIT OF APPLICANT X60 1. No work will be started before a permit is ISSUED AND POSTED. 2. For comrnarciat permits, a set of plans for this project must be submitted to the Nebraska date Fire Marshal's Office for review. 3. Separate permits are required for eleclricat. plumbing, heating, ventilating and airconditloning, and -septic system. 4. The undersigned owner or agent understands and acknow)edges this building permit application does not constitute issuance of this building permit. It is further understood that construction covered ay+ this permit application shall not be commenced until a copy of a permit signed by the Building Inspector Is issued. S. The underaigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and in accordance with the codeslordinancee of the City of Glair and the State of Nebraska. Any omission of or misrepreventatian of fact with or without the intention of the undersigneat or any alteration or cbsnge from this application without approval of the Building Offrclai, ail oonstitu�cient ground for the revocation of any permit issued which was based on the approval of INS applica#i Date Signalum of A4ppitcan i I