MS-2014-01454.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 -FAX
MS- 2014 -01454 ise of auk\` www.blairnebraska.org I,
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07/21/2014 ShellyJ MISC Residential July 21, 2014
� E LOCATION OF IMPROVEMENT: 10980 CR 29, Blair, NE 68008
ARCHITECT:
_R GENERAL Eireann Construction Inc
a- OWNER: Vince Bruce CONTRACTOR: 9683 Maple Dr
1 ®�
OMAHA, NE 68134
12937 Laurel Ave
Omaha, NE 68168
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 07/20/2016
10980CR29- 140721 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Reroof, gutters, siding and windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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. j
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of j
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 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 p
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