643.tif CITY0FBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426-4191 - Phone
10:00HUMMMM Building Permit Application
-4195 - FAX
(402)426
MS-2014-00643 0 ise 01 www.blairnebraska.org
06127/2014 MISC Residential June 27, 2014
LOCATION OF IMPROVEMENT: 2155 Front St, Blair, NE 68008
ARCHITECT: GENERAL FIS Contracting
CONTRACTOR: 324 S 13th St
OWNER: Anne T Keenan
Tekamah, NE 68061
4024 Grand Ave Apt 104
DES MOINES, IA 50312-3500
52
� I Ra s
NO
We
I SIMMONS 11M
WE ....... ..... .. . ...
% MEM ON OMNI
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence 0612612016
PERMIT EXPIRES
PROJECT NAME
2155FrontSt-140627-2014 Storm Damage ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roofing, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMGheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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
faul. with or without the intention of the undersigned or any alteration or rhange from this application without approval of the
Building Offic' 1, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a io 7
It
Date
Signature pplicant