798.tif CITYOFBLAIR
218 S.16TH STREET
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BLAIR, NEBRASKA 68008
1 Application (402) 42644191 -Phone
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(402) 426 -4195 - FAX
I MS -201 400798 g 11 www.blairnebraska. ®r
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07/02 MISC I Resid duly 2, 2014
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LOCATIONOFIMPROVEMENT: 1265 Colfax St, Blain, NE 68008
ARCHITECT:
GENERAL Global R and C, LLC
OWNER: Emile R Cordle CONTRACTOR: 6721 NW 6th St
LINCOLN, NE 66521 i
2025 Soren Dr
ECLAIR, NE 680080000 I
T 77777
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NATURE OF WORK STRUCTURE i
Primary Residence
Storm Repair i 1
P NA �
PERMIT EXPIRES 071011201
1265ColfaxSt- 14070242014 Storm Damage 12131/2014
E STIMATED M L TI O N DAT
DESCRIPTION O WORK E
Roofing, gutters, wding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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.
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
app do .
- -_- Date
Signature of Applicant