MS-2014-01647.tif ^
CITYOFBLAIR
21BS.16THSTREET
BLA|R, NEBRASKA 68008
U ^ ^
Building Permit Appcaton (402) 426-4196 - FAX
MS-2014-01647 Ise www.blairnebraska.org
07/2512014 ISC — T — Residential July 25, 2014
T
LOCATION OFIMPROVEMENT: 414 N 19th St, Blair, NE 68008
ARCHITECT: GENERAL SELF
OMER: Mary Beth Thallas CONTRACTOR:
414 N 19th St Blair, NE 68008
BLAIR, NE 68008-0000
PO
M
M
INS 0011 PENN
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PERMIT EXPIRES 07124/2016
PROJECT NAME
414Nl9thSt-140725-2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, siding, windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
mESu.=""^"^^""""=ck="=M'''ED' NA
DEPOSIT STATUS: ' 80LD|NG PLANS SUBMITTED: NA
1. No work will be started before a permit is |GGUEO AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska 8baba Fire Marshal's Office for rev
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned owner nragent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It ia further understood that construction covered by this permit application shall not be commenced until a
copy of permit signed by the Building Inspector is issued.
5. The undersigned owner oragent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codes/ordinances of the Qty of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with nr without the intention of the undersigned or any alteration or change from this application without approval of the
Building OMicie|, ohoU constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicati
_^�, � Date or�p�xoo�t
(/