554.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
. U ° i0 "1.s� Bu ilding I Application (402) 426 -4191 -Phone
a� (402) 426 -4195 - FAX
MS -2014 -00554 ° '17ise of a`' www.blairnebraska.org
06/25/2014 MI Residential June 25, 2014 OMM
LOCATION OF IMPROVEMENT: 1051 S 17th Ave, Blair, NE 68008
ARCHITECT:
GENERAL Ambassador Home Improvement
OWNER: Kimberly J Howard CONTRACTOR: 19688 Birdsley Rd
COUNCIL BLUFFS, IA 51503
1051 S 17th Ave
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
P ROJECT NAME PERMIT EXPIRES 06/24/2016
1051S17thAve- 140625 -2014 Strom Damage
ES TIMATED PL TION DATE 12/31/2014
DESCRIPTION OF WORK
Shingles, siding, windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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
Bu ilding Official, sh nstitute sufficient ground for the revocation of any permit issued which was b e approval of this
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