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CITYOF BLAIR j
218 S.16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 2 -4191 -Phone
(402j 426 -4195 -FAX
MS -2014 - 00626 '11S of o,� www.blairnebraska.org
06126/2014 7 mlsc Residential June 26, 2014
LOCATIONOFIMPROVEMENT: 2000 Northridge Cir, Blair, NE 68008
ARCHITECT;
1 ,{ GENERAL Pyramid Roofing
CONTRACTOR;
OWNER; Sandra K Hearn 9504 S Sa
ddlecreek Rd
, 7p Omaha, NE 68106
2000 Northridge Cir
X75`, BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/2512016
2000NorthridgeCir- 140626 -2014 Storm
Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roofing, gutters, siding, windows
DEPOSIT PAID BY. SITE PLAN SUBMITTED: NA
Contractor
RESchecklCtOMcheck SUBMITTED; 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 Official, shall constit to sufficient ground for the revocation of any permit issued which was based on the approval of this
plication.
Date
Signature of Applicant
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