20140709101954733_0004.tif CITYOF BLAIR E
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application
(402) 426 -4191 -Phone r
(402) 426 -4195 - FAX
MS -2014 -00970 °wise of av� www.blairnebraska.org
07108/2014 MISC Residential July 8, 2014 I
LOCATIONOFIMPROVEMENT: 972 N 24th Ave, Blair, NE 68008
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ARCHITECT: GENERAL D & M Construction
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OWNER: Myra M And Robert C Sr Co- Trustees Larsen CONTRACTOR: 3538 S 48th Ave
OMAHA, NE 68106
972 N 24th Ave
BLAIR, NE 68008 -0000 f
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 07/07/2016
972N24thAve- 140708 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roof, siding, gutters, windows
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
fth or without the intent' n of the undersigned or any alteration or change from this application without approval of the
g Official, shall constit a sufficient ground for the revocation of any permit issued which was based on the approval of this
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S gn ture of Applicant Date