MS-2014-01553_0001.tif i
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CITYOF BLAIR
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218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS -2014 -01553 1 0 �;S °s q www.blairnebraska.org
07/2212014 MISC Residential July 22, 2014
LOCATIONOFIMPROVEMENT: 1952 Grant St, Blair, NE 68008
® ARCHITECT: GENERAL SELF
®1 OWNER: CONTRACTOR:
Blair, NE 68008
1952 Grant St
BLAIR, NE 68008 -0000
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7 !!7 "�i� "�"�. =- _ ,s „�;_��""'s2 :��"��7''`�*� —,.�" 'z ".{� `�.�s����r r � v..;��",.� ..,�:��^�,.� -2:. ^`�`�,Y ��:G- .�.�.�. -,� � a NATURE OF WORK RUCTURE
Storm Repair rimary Residence PROJECT NAME RMIT EXPIRES 07/2112016
1952GrantSt- 140722 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
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DESCRIPTION OF WORK
Roof, siding, windows, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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 ndersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in cordance with the odes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fac with or without t intention of the undersigned or any alteration or change from this application without approval of the
B ding fficial, shal onstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
lica n.
Signatu of Apoi ant Date