676.tif i
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008 !
1 I I I a i 4264191
(402) Phone
Building Permit Application 402 426
l '
(402) 426 -4195 FAX j
MS 2014 - 00676 4a o �_ q d www.blairnebraska.org
06/27/2014 !i MISC Residential June 30, 2014
LOCA110NOFIMPROVEMENT: 833 N 26th Ave, Blair, NE 68008
ARCHITECT:
GENERAL Home Pride Contractors, Inc.
rr OWNER: Shawna A Tierney CONTRACTOR: 5202 "Q" 5t
Omaha, NE 68117
833 N 26th Ave
BLAIR, NE 68008 -0000
97--77 777'7777T�
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NATURE OF WORK STRUCTURE
Storm Repair Priamry Residence
PROJECT NAME PERMIT EXPIRES 06126/2016
833N26thAve- 140627 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED:
NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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 constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
ap Iicalort.
Sign ture of Applicant to
4.
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