MS-2014-01765.tif I
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AA 4. 2014 10:31 ADAM ADC Homes BLAIR (402, 426, 4141) N0, • 82,23j0 P.. • 2 1
DITYOFt3LAIR
218 6,1 6TH STREET
` BLAIR, NEBRASKA 68000
Bu ilding Pe rmit Application (402) 426.4191 - Phone
(402) 420-4105 - FA
MS T2014y09765 www.l�►a ®b
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07/29/2014 MISC Residentfal July 23, 201
LOC,'ATION OFIMPROVEM ENT: 1930 Washington St, Blair, NE 615000
� ARCHITECT'
i GENEPAL Advance Design & ConstrUotion Inc
r OUTER Daniel L And Dean L Kl oster COWRACTOR:
" 16 002 A Olr
9930 Washington St OMAHA, NE 68144
BLAIR, NE 69008.0000
NATURE OF WORD STRUCTURE
Storm Repair Primary Residenos
PROJECT NAME PERMIT EXPIRES 07/2812016
1830 aehingtonSt- 'I4072,0 2014 Starm
Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roof, gutter:, siding, windows, paint
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheak/CoMcheckSUBMITTED: NA
DEPOSIT STATUS BUILD PLANS SURMITTE NA
Fl-
,D,
1. No work will be et:Rrted before a permit is I SU ED AND POSTED,
2. For commercial permits, a set of plans for this project must be submitted to the Nebrasks,Stale Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, verltilafing and air oanditi0rtll,g, and .septic system.
4. The undersigned owner or agent 4nderstands and soknowledges this building permit application does not conslitute Issuance of
this building permit. it is further under$tood that construction covered by this permit appiic$ lion shall not be commenced until a
topy of a permit signed by the wilding I n spector is Issued,
b.The undersigned owner of ,agent agrees to perform the proposed work in accordance with the specifications set forth, above and
Its sccordance with the codesfordinences of the City of Elair trod the Stale of Nebraska. Any omission of or nikrepresentation of
fact With or without the intention of the undersigned or any al(erolion or Change from this application without appr of the
Building Official, shall cona(ifulo s Mcien( ground for the revocation of any permit issued which was based on the approval of this
application.
Date
Slgnatur of applicant
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