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CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building P @1"mit App��Catiort (402) 426 -4191 - Phone
(402) 426 -4195 -FAX
MS- 2014 - 00658 ise a�� www.blairnebraska.org C
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06/27/2014
MISC Residential June 27, 2014
LOCATIONOFIMPROVEMENT: 9071 Cord P33, Blair, NE 68008
®i ARCHITECT: GENERAL F/S Contracting
OWNER: Howard D Jr And Kristie E Thompson CONTRACTOR: 324 S 13th St
Tekamah, NE 68061
9071 Co Rd P33
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06126/2016
9071 Cord P33- 140627 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roofing, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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
application.
Signature of Applicant Date