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CITY OF BLAIR
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218 S. 16TH STREET I
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B LAIR , A 66008
- Phone
B uilding Permit Application
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(402) 4264195 - FAX
MS- 2014 -00687 ����;,��; �,� �a °" www .blairnebraska.org j
06127/2014 MISG Reside Jun 2 7 , 2014 ,
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LOCATION OF IMPROVEMENT: 1 766 State St, Blair, NE 68008
ARCHITECT. GENERAL Global R and O, LLC
OWNER: Dennis And Wt Cordle WNTRACTOa: 6721 NW 6th St
w LINCOLN, NE 68521
1766 State St 1
BLAIR, NE 68008 -0000
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NATURE OF VWC}RK STRUCTURE
Storm Repair Primary Residence
P RO JECT NAME PERMIT EXPIRES 06ef26/201
1766StateSt- 140627W2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roofing and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck 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 constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicati
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Signature o plicant Date