MS-2014-01764.tif I
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AUG. 4. 2014 10:31AKAM ADC Homes GLAIR (442. 426. 4191) NO. 822330 P. 3 2
CITYOFIBLAIR
216 8,16TF1 °TREET
SL.A NEi3BASKArozou
Building Permit Appl (402) 426.4 . Phone
(402) 426.4105 - FAX
M$--2014-01764 � mtse of a ��� www.blairttebraska,org
1 07/2t/201 '' 4 , MISC Resideniial Mrm -July2g,2014 I
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LOCATIONCFIMPROWMFNT: 114 James Dr, Blair, NE 68006
ARCHITECT.
GENERAL Advance design & Construction Inc
me OWNER: Clarence And WE Dronnerf r;QMFiA TCIR:
16002 A C j
. i'i54 James br • OM NE 68144
BLAIR, NE 66008-0000
NATURE OF WORK STRUCTURE
Storm Repale Primary Residence
PROJECT NAME PERMIT EXPIRES 07/2812016
116 4JamesDr- 14072,8 -2014 Storm D amage ESTIMA COMPLETI DA TE 12
DESORiPTION OF WORK
Roof, gutters, siding, painting, windows
DEPOSIT PAID IaY: SITE PLAN SUBMITTED: NA
Contractor
RESaheek/CQMchcok SUBMITTED: NA
OF-POSIT STATUS: BUILDIN PLANS SUBMITTED: NA
AFF A I )AVIT * ,..
1_ No work will be started before a permit is ISSU Q AND POSTED.
2. For commercial permits, a set of plans for this project must ho submitted to the Nebraska State Fire Marshat's Office for review.
3. Separate permits are required for electrical, plumbing, heetitre, ventilating and 0ir conditldttino, and septic system,
4. The undersigned owner or agent undeTSlands 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 signets by the Building Inspector Is Issued.
6. The undersigned owner or Agent egress to pp4orm the proposed work in accordance with the specifications set forth above and
in accordance Oth the lodes /ordinances of the City of Blair and the State of Nebraska. Any omisslon of or rnlerepresentatipn of
fact with or without the Intentlotn of the undersigned or any alteration or change from this application without approval of the
190ding Ofiloleti, Shall constitute sufficient gro r the revocation of any permit issued which was based on the approval of this
application,
Jo� zl�A �e2.4-
Ditto SignAture Of APpr It
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