720.tif i
I
CITY OF Bt AIR
218 S. 16TH STREET
j BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
F,`II'I_I_ , Building Permit Application (402)4264195 -FAX
MS- 2014 -00720 � fofi`5 o q � ° ° www.blairnebraska.org
MISC R esidential June 30, 2014
06/30/2014
LOCATIONOFIMPROVEMENT: 1081 S 16th Ave, Blair, NE 68008
ARCHITECT: GENERAL Home Pride Contractors, Inc.
CONTRACTOR:
OVvNER: Donald P And Tracy R Bingham Adams 5202 "Q" St
Omaha, NE 68117
k.
1081 S 16th Ave
'�
BLAIR, NE 6$008 -0000
NATURE OF WORK STRUCTURE
Primary Residence
Storm Repair
PERMIT EXPIRES 06/29/2016
PROJECT NAME
1081S16thAve- 140630 -2014 Storm Damage ESTIM COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof only
E DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
i —
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
apps cation
Date
Signatu e of Applicant fi
I