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Jun.26.2014 05:26 PM PAPILLION WINDOWS & SIDIN 4025971777 PAGE. 0/ 4
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218 S. 16TH STREET
ESL.AIR, NEBRASKA 68008
- 1 B uilding Permit Application (402) 426 -4191 - Phone 1 (402) 426 -41 - FAX
- 201 4 -0051 9 �� aE '�'���, www.blalrnebraska.org
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;/24/2014 MISC Residential June 24, 2414
LOCATION DFIMPRUVE:MENT: 12646 US Hwy 30, Blair, NE 68008
ARCHITF-CT: 'GENERAL Papillion Windows & Siding
OUIMER: Tray And Elizabeth Soderberg CONTRACTOR: 1230 Royal Dr Ste 2
PAPILLION, NE 58045
3012645 s Hwy
i
BLAIR, NE 68008 -0000
NAT U- RE OF WORK STRUCTURE
Storm Repair Primary Residence
)RODE T NAME PERMIT EXPIRES 06/2=0116
12645US H wy 30-140624-2014 Storrs ESTIMATED COMP LETION DATE 1=1/2014
Damage
)ESGRIPTION OF WORK
Replace roof, gutters, replace garage door
)EPOSIT PAID BY: S ITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheak SUBMITTED: NA
)EPOSIT ;STATUS: BUILDING PLANS SUBMITTED: NA
1 1 1 * + • IRMA III
No work will be started before a permit is ISSUED AND PO$TEO.
„ For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's office for review.
Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
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.
The undersigned owner or agent agrees to perform the proposed work i accordance with the specifications set forth above and
in accordance with the codeslordinances 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 Official, s ll constitute sufficient ground for the revocation of any permit issued which was fused on the approval of this
$pp ation.
Da
In$# re of Applicant