MS-2014-01906.tif I
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CITYOFBLAIR
218 S. 16TH STREET
f BLAIR, NEBRASKA 68008
u'I 'n Permit Applicatio
(402) 426 -4191 - Phone
y ��+ (402) 426 -4195 - FAX
MS -2014 -01906 se of aJ�\` www.blairnebraska.org
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Y
2014
Shell J MISC Residential August 4, 2014 j
08/04/
LOCATIONOFIMPROVEMENT: 1051 N 26th Ave, Blair, NE 68008
ARCHITECT:
GENERAL Nielsen Home Improvement
OWNER: Randall L Smith
CONTRACTOR:
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1023 W Superior
Missouri Valley, IA 51555
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BLAIR, NE 68008 -0000 f
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NATURE OF WORK STRUCTURE [
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 08103/2016
1051 N26thAve- 140804 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Reroof and siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: 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 he codes/ fdina es of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with o witho t the i ention the undersigned or any alteration or change from this application without approval of the
Building fficia shall nstitu sufficient ground for the revocation of any permit issued which was based on the approval of this
applic on.
Date
Signat re of Applicant
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