729.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
1 I I Application (402) 426 -4191 -Phone
v � (402) 426 -4195 - FAX
-2014 -00729 ° wise of Q� www.blairnebraska.org
06130/2014 MISC Residential June 30, 2014
LOCATION OF IMPROVEMENT: 10583 Cord 29, Blair, NE 68008
ARCHITECT:
GENERAL Roof -Tech Inc.
OWNER: Todd S And Julia M Fielding CONTRACTOR: 8998 L St 230
OMAHA, NE 68127
29 10583 Co Rd
BLAIR, NE 68008 -0000
NA T URE K STRUCTU
Storm Repair Primary Residence
PROJEC NAME PERM EXPIRES 06/29/2016
10583Cord 29- 140630 -2014 Storm Damage
ES TIMA TED L TI N DA TE 12/31/2014
DESCR IPTION F WOR
Re- roofing
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
y
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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
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Signature of Applica t Date