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i x I CITYOFBLAIR 218 S. 16TH STREET BLAIR, NEBRASKA 68008 {p Building Permit Application (402) �a6 .4181 Pho r : ,�, (402) 426.14196 - FAX 23 �.,, rQr� www.blairnebraska. ©rg �7 6/26/2014 � MIS C Residential June 26, 2014 3 LOCATIONt FIMPROVEMENM 11323 Rambleridge Dr, Blair, NE 68008 1 ARCHREC7 GENERAL. Hometown Roofing, Inc, OMER: Michael R And Kerry A Jonas =JrF' ACTOR: 13318 Millard Ave Omaha, NE 68137 FLAIR, WE 68008 -0218 NATURE O WORD STRUCTURE Storm 12epaiir Primary Residence PROJECT DAME PERMIT EXPIRES 06/2512016 11323Raetlbl�eridgeDr- 140626 -2014 Storm ESTIMATED COMPLETION DATE 1213112014 Damage DESCRIPTION OF WORK Roofing only DEPOSIT PAIL} BY: SITE PLAN SUBMITTED: NA Contractor RESchecklCt)Mcheck SUBMITTED: NA DEPOSIT STATUS: BUILDING PLANS SUBMITTED. NA 1. No work will be started before a permit is ISSUED AND POSTED. 2. For commemial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review. 3. Separate pe mits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system. t. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of this building 1permit. 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 o1 fact with or lwithout the intention of the undersigned or any alteration or change from this application without approval of the Building Offilial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of thi. applicat' n. ' k ?uail ignatur+e of Applicant Date i T 92ed P - q T +,gRRP-n+, WH A 11r N - gc;H1 AH WHR? : n T b T np. I.?' un