Application_0001 (2).tif i
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CITYOFBLAIR
218 S. 16TH STREET
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BLAIR, NEBRASKA 68008
Building Pe1" I t Application (402) 426 -4191 - Phone
M S- 2014 -00839 .ohs._- a�� ° (402) 426 -4195 -FAX
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of www.blairnebraska.org
07/03/2014 Shelly) MISC Residential July 3, 2014
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% LOCATION OF IMPROVEMENT: 2025 Wright St, Blair, NE 68008
ARCHITECT:
GENERAL Scott Stang)
OWNER: Scott M And Theresa J Stangl CONTRACTOR: 6436 Northern Lights
v FORT CALHOUN, NE 68023
6436 Northern Lights Ln
FT CALHOUN, NE 68023 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 07/02/2016
2025WrightSt- 140703 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Replace shingles
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 e intention of the undersigned or any alteration or change from this application without approval of the 12
Buildin Offici , sh .11 onstitute fficient ground for the revocation of any permit issued which was based on the approval of this
applic ion.
Date
Signature of Applicant
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