Permit Application (8).tif j
CITYOF BLAIR
218 S. 46TH STREET
BLAIR, NEBRASKA 68008
- wilding PermitAppliCafion (402) 426 -4185 -FAX
426 -4191 -Phone
(402}
MS- 2014 -01001 a ` °mr of www.blairnebraska.org
07/0812014 Shelly) MiSC
Residential July 8, 2014
LOCATIONOFIMPROVEMENT: 1806 South. St, Blair, NE 68008
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D ARCHITECT: GENERAL K R T Construction
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01. OVWNER: Maxine Therk CONTRACTOR 12619 Burt St
n e , Omaha, NE 68154
1806 South St
GLAIR, NE 68008 -0000
NATURE OF WORK S TRUCTU RE
Primary
Storm Repair
I
PERMIT EXPIRES 07/07/2016
PROJECT NAME
1806SouthSt- 140708 -20 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Reroof and siding
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.
& 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 Offlc1�1 shall constitute sufficient round for the revocation of any permit issued which was based on the approval of this
applicatio ✓'
Signature Applicant