MS-2014-01432.tif 4
CITYOFBLAIR
218 S,16THSTREET
y BLAIR, NEBRASKA 68008
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MS- 2014 ®01432 vwvw.blairnebraska.org
07("18/2094 MISS Residential July 18, 2014
LOCATION OF IMPROVEMENT: 1219 South St, Blair, NE 68008
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ARCHITECT. GE Universal Roofing
OWNER: Deborah M Heinssen C ONT1 ACTOR* 10605 Bondesson Cir
OMAHA, NE 68122
_ 1219 South St
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
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Storm Repair Primary Residence
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` PROJECT NAME PERMIT EXPIRES 0711712016
1219SouthSt- 140718 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/
DESCRIPTION OF WORK
Roof, siding, gutters, windows
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DEPOSIT PAID BY: SITE FLAN SUBMITTED; NA
Contract
RESchecklCOMcheck 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 codeslordinances 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 Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
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Signature of Applicant teats