MS-2014-01218_0001.tif i
CITYOF BLAIR
218 3.16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402 -4191 -Phone
(402) 426 -4195 - FAX
;07S114/2014 - 2014 - 412'1$ .,W� vwvw.blairnebraska.org
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MISC Residential July 14, 2014
LOCATIONOFEMPROVEMErrT: 11324 Rambleridge Dr, Blair, NE 68008
ARCHFFECT:
GENERAL Hometown Roofing, Inc.
0W4ER: ClItarles F And Vickie A Joe CONTRACTOR. 13316 Millard Ave
Omaha, NE 68137
11324 Rambleridge Dr
BLAIR, NE 68008 -9803
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NATURE OF WORK STRUCTURE
storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07113/2016
11324RambleridgeDr440714 -2014 Storm ESTIMATED COMPLETION DATE 12/31/201
Damage
DESCRIPTION OF WORK
Roof, gutteri
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 buildingi 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 codeslordinances 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
application., _
Date
Signature of Applicant
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