MS-2014-01294.tif CITYOF BLAIR
218 S. 16TH STREET k
BLAIR, NEBRASKA 68008
W- 211 r B uilding Permit Application
(402) 426 -4191 -Phone
(402) 426 -4195 -FAX
MS- 2014 -01294 'on, of a �° www.blairnebraska.org
07/16/2014 MISC Residential July 16, 2014
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LOCATION OF IMPROVEMENT: 1349 Nebraska St, Blair, NE 68008 I
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ARCHITECT: GENERAL Blackstone Exteriors I
OWNER: John Eric Lee Barnes CONTRACTOR: 1200 HWY 92, Suite B
Winterset, IA 50273
1349 Nebraska St
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BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/15/2016
1349NebraskaSt- 140716 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
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DESCRIPTION OF WORK
Roof, siding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: 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
or the revocation of an
Building O tal, shall constitute sufficient ground f y p ermit issued which was based on the approval of this
applicati
Sig a re of Applicant Date
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