MS-2014-01456_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
- r����= (402) 426 -4195 - FAX
MS- 2014 -01456 QO M /se of ago www.blairnebraska.org
07/21/2014 MISC 77 Residential July 21, 2014
LOCATIONOFIMPROVEMENT: 1520 Butler St, Blair, NE 68008
ARCHITECT: GENERAL Exterior Remodel and Design
OWNER: Martin D Hrnicek CONTRACTOR: 14225 Dayton Cir
OMAHA, NE 68137
1520 Butler St
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 07/20/2016
1520ButierSt- 140721 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roof, gutters, windows, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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 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 co es /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or a 'ntention of the undersigned or any alteration or change from this application without approval of the
Building ffici situte sufficient ground for the revocation of any permit issued which was based on the approval of this
applic ion
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Date
Sign o Applicant