1327.tif CITYOF BLAIR
216 SA GTH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 26 -4 1 9 -Phone
{402) 26.4195 -FAX
MS - 2014 -01327 �Q www.lairnebraska
07116/2014 MISC Residential July 16, 2014
• LACATIONOFIMPROVEMENT 11323 Rambleridge Dr, Blair, NE 68008
N ARCHITECT GENERAL Hometown Roofing, Inch.
A OWIER: Michael R And Kerry A Jonas CONTRACTOR: 13316 Millard Ave
Omaha, HE • 68137
BLAIR, NE 68008 -0218
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/1512016
11 323Ramblerid eDr- 140716 -2014 Storm '
Damage
B ESTIMATED COMPLETION DATE Ix/31/2014
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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 Mars 'al's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic Oystem.
4. The undersigned owner or agent understands and acknowledges this building permit application does of constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall n 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 specifics 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 basgd on the approval of this
applicatio
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Signatur of Applicant Data
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