706.tif CITYOFBLAIR
f ` 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS -2014 -00706 , oo , ��° � www,blairnebraska.org
06!34/201 MISC Residential June 30,2014
LOCA110NOFIMPROVEMENT: 254 N 21st St, Blair, NE 68008
.� ARCHITECT:
GENERAL Home Pride Contractors, Inc.
OWNER: Doris G, Trustee Stokes CONTRACTOR: 5202 "Q" St
Omaha, NE 68117
254 N 21st St
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/29/2016
254N21stSt- 140630 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/3
DESCRIPTION OF WORK
Roofing and gutters
DEPOSIT PAID BY; SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED; NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
t C-
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
application..
Date
Signature of Applicant
E