MS-2014-01262.tif cITYm8LAIe
218S.16THSTREET
BUuR NEBRASKA 680O8
Permit Building Application (4Qq4us4181 Phone
MS-2014-01262 www.bleirnebraska.org
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MISC Residential July 15, 2014
13625 Spring Ridge Loop, Blair, NE 68008
W - ARCHITECT., GENER41L Total Roofing Company
OWNER Nielsen Homes and Development Inc CONTRACTOR- 10501 Chandler Cir Rm 100
LAVISTA, NE 68128
1730 State St
BLAIR, NE 68008-0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/1412016
13625Spring Ridgel-oop-1 40715-2014 Storm ESTIMATED COMPLETION DATE 12/3112014
Damage
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheckICOMcheek SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1.No work will be started before u permit iu 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, heafing, 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 ufa permit signed by the Building Inspector iaissued.
5. The undersigned owner oragent agnaoa to perform the proposed work in oouondanoo 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 intention of the undersigned or any alteration or change from this application without approval of the
Building Ofhcia\, xhoU constitute sufficient ground for the revocation of any permit issued which was based on the approval ofth\e
Date
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