MS-2014-01709_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
v �• (402) 426 -4195 - FAX
MS -2014 -01709 Ise of www.blairnebraska.org
0712812014 MISC Residential July 28, 2014
LOCATIONOFIMPROVEMENT: 2141 Crestridge Dr, Blair, NE 68008
D ARCHITECT: GENERAL SELF
OWNER: Lisa L Sonderup CONTRACTOR:
2141 Crestridge Dr Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 0712712016
2141 CrestridgeDr- 140728 -2014 Storm
ESTIMATED COMPLETION DATE 12131/2014
Damage
DESCRIPTION OF WORK
Roof, siding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 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 Offici I, shall constitute suffi 'mound for the revocation of any permit issued which was based on the approval of this
app ' ati
Date
Sig ture of Applicant
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