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CITY bF BLAIR
218 S.16TH STREET
t i r SLAI& NEBRASKA 68008
I Bundling Permit Applica (402) 426 -41$1 - Phone
(402) 426 -4186 -FAX
MS -2014-01326 x Q V _#e e Ot; . www blaimebraska.org
07116/2014 MISC Residential July 16, 2014
• LOCATIONOFIMPROVEMENT: 2207 South St, Blair, NE 60008
ARCHITECT: i
r GENERAL Hometown Roofing, Ind.
OMER. Kent W And Wf Thomas CONTRACTOR; 13316 Millard Ave
Omaha, NE 68137
2207 South St
BLAIR, NE 68008 -0000 j
i
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 071181201
2207SouthSt- 140716 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchock/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1 l�. Q s • Y
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 �ystem.
4. The undersigned owner or agent understands and acknowledges this building permit application does riot constitute issuance of
this building permit. It Is further understood that construction covered by this permit application shall n�t be commenced until a
copy of a permit signed by the Building Inspector is issued.
6. The undersigned owner or agent agrees to perform the proposed work in accordance with the speclfical ions set forth above and
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission c f 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
applicatio
& I)A A'
Signature of Applicant
Date
T abed ZS T 1796820117 Xdd 13CN3Sd dH Wdipo :6 tr T oa 62 i nC