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CITYOF GLAIR
218 S.16TN STREET
BLAIR, NEBRASKA 68008
Building Permit Application (aoz) 426- 4191 -Phone
y _.. (402) 426 -4195 FAX
MS- 2014 - 0'1009 a ` °n, o � a� °` www.blairnebraska.org
07!0812074 She11yJ MISG Residential July 8, 2014
LOCATIONOFIMPROVEMENT: 1806 South St, Blair, NE 68008
D ARCHITECT: GENERAL K R T Construction
CONTRACTOR 12619 Burt St
a � 'OWNER: Marine Therkelsen
Omaha, NE 68154
1806 South St
BLAIR,NE 68008 -0000
T .'i;' a,'�' : ;c". __ Y `�` '�Y'=S - 7 ,ti = . -�.- - �.�"�?'��'_ �� ��1 a� �� a � � � :? - a� - �_ ,.�. � - �`v�t�<a ° - OF WORK
STRUCTURE
pair Primary
PROJECT NAME PERMIT EXPIRES 07/07/2016
1806SouthSt- 140708 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Reroof and siding
DEPOSIT PAiD BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 Offici i shall constitute s round for the revocation of any permit issued which was based on the approval of this
applicatio
pate
Signature Applicant
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