20140711155206244_0003.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 - Phone
MS- 2014 -01167 .o 'o� (402) 426 -4195 -FAX
ise of a www.blairnebraska.org
07/1112014 M ISC Residential July 11, 2014
d LOCATIONOFIMPROVEMENT: 2045 Wright St, Blair, NE 68008
L, ARCHITECT: GENERAL S & R Roofing Solutions
OWNER: Josh And Jennifer Knowles Stolz CONTRACTOR: 17235 Rampart St
®' OMAHA, NE 68136
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2045 Wright St
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 07/10/2016
2045WrightSt- 140711 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Reroof, siding, gutters and windows
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 j
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 )Ad without the intention of the undersigned or any alteration or change from this application without approval of the
II ing Officials onstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicai
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Date
Signature of Applicant
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