840.tif CITYOFBLAIR
218 S. 16TH STREET
j ! B LAIR, NEBRASKA 68008
Building r 1t Application (402) 426 -4181 - Phone
402 42 -4
MS- 2014 -00840 ( ) 6 19s - FAx
mIs e of a www.blairnebraska.org
107/0312014 MISC Residential July 3, 2014
LOCATIONOFIMPROVEMENT: 658 N 13th St, Blair, NE 68008
ARCHITECT:
GENERAL That Construction Company
OWNED= Marcy L Bottorff CONTRACTOR:
7200 S 84th St
658 N 13th St
LAVISTA, NE 68'128
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 0710212016
658N13thSt- 140703 -2014 Storm Damage
ESTIMATED COMPLETION DATE 7/3/2016
DESCRIPTION OF WORK
Re roofing and residing
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
E Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS:
BUILDING PLANS SUBMITTED: Pending
a' 1
I. 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 wiKonsti ut the intenti of the undersigned or any alteration or change from this application with appr val of the
Buildin s all c sufficient ground for the revocation of any permit issued which was based oIth ap p val of this
applica
Signature of Applicant Date