597.tif CITYOFBLAIR
- 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
rM _ UIlC�II"lg @I'1111t ApplICatlOn (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
S- 2014 -00597 pr ° Is e of a www.blairnebraska.org f
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[06/26/2014 MISC Residential June 26, 2014
LOCATION OF IMPROVEMENT: 1467 Adams St, Blair, NE 68008
ARCHITECT: GENERAL F/S Contracting
OWNER: Katherine M Ruby CONTRACTOR: 324 S 13th St i
Tekamah, NE 68061
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1467 Adams St
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/25/2016
1467AdamsSt- 140626 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roofing, gutters, siding
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RES check/CO Mcheck 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 f
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the r-
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
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Sig ature of / pplicant Date
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