810 (3).tif I
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CITYOF BLAIR j
218 S. 16TH STREET
�x BLAIR, NEBRASKA 68008
Permit Application
(402) 426 -4191 -Rhone
Building (402) 426 -4195 - FAX
MS - 2014 -00810 ' °�f www.blairnebraska.org
IS o I
[0�7102/2014 July 2, 2014
M I SC Residential
LOCATION OF IMPROVEMENT: 2047 Northridge Cir, Blair, NE 68008
ARCHITECT: GENERAL Absolute Roofing
CONTRACTOR:
OWNER: Christopher J And Cynthia K Heng 17330 W Center Rd Ste 110
OMAHA, NE 68130
2047 Northridge Cir
BLAIR, NE 68008 -0000 "%.
NATURE OF WORK STRUCTURE
Primary Residence f
Storm Repair
PERMIT EXPIRES 07/01/2016
PROJECT NAME
2047NorthridgeCir- 140702- 2014 Storm ESTIMATED COMPLETION DATE 12/31/2014
Damage
DESCRIPTION OF WORK
Roofing and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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d x 5!
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
ion of
in accordance with the codes /ordlnances of the City of Blair and the State of Nebraska. has omissio o f
without ap prova l t oo the
fact with or without the intention of the undersigned or any alteration or change from app
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Date
Signature of Applicant