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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
(402) 426 -4196 - FAX
MS -2014 -00755 a` ° fiise os a� °" www.blairnebraska.org
07/01/2014 MISC Residential July 1, 2014
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s LOCATION OF IMPROVEMENT: 1403 Wright St, Blair, NE 68008
ARCHITECT:
GENERAL The Roofing Moose
OWNER: Stephen B And Anya J Fullmer CONTRACTOR: 20164 Husker Dr
emu' GRETNA, NE 68028
1403 Wright St
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/30/2016
1403WrightSt- 140701 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roofing, gutters, downspouts, gutter protection
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
Bu' ' g Official, hall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app n. le, 02-
Sig p t+nt Date
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