MS-2014-01573_0001.tif i
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CITYOFBLAIR
218 S.16TH STREET
BLAIR NEBRASKA 68008
Building Permit Application (402) 426- 4191 -Phone
(402) 426 -4195 - FAX
MS -2014 -01573 °�sa qS q0�` www.blairnebraska.org
07/23/2014 MISC Residential July 23, 2014
', LOCATIONOFIMPROVEMENT: '1123 N 18th Ave, Blair, NE 68008
a .ARCHITECT:
GENERAL, Pyramid Roofing
OWNER: Denise J Ray CONTRACTOR: 1504 S Saddlecreek Rd
Omaha, NEB 68106
1123'N 1 8th Ave
i BLAIR, NE 68008 -000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 07/22/2016
1123N18thAve- 140723 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roof, siding, gutters, windows, paint
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: 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
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 with or without the inte ' of the undersigned or any alteration or change from this application without approval of the
Building Official, shall con Itute s fficient ground for the revocation of any permit issued which was based on the approval of this
pplication.
Signature of Applicant Date