MS-2014-01441.tif i
I
I
i
CITYOFBLAIR
218 S.,! 6TH STREET
BLAIFIw,NEBRASKA68008 j
' - • - �` u Building Permit Application (402) L�w -4191 -Phone
s (402) -4185 -FAX
:20: - 0'1
. www. irnebr aska.org
07118/2014 intern MISC Residential July 23, 2414
LOCATIONOFIMPROVEMENT' 11098 Co Rd P29, Blair, HE 68008
M ARCHITECT:
b GENERAL. Hometown Roofing, Inc.
• OVWER. WILLIAM E & ANDREA V DICKERSON CONTRACTO
13316 Millard Ave
E. 11096 Co Rd P29 Omaha, NE 68137
Blair, NE 68008
w
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 0 7/17/2016
11096Co Rd P29- 140718.2014 Storm damage ESTIMATED COMPLETION DATE 1213112014 k
C
DESCRIPTION OF WORK
Roofing, gutters, siding, windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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 inot 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 /ordlnances 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 ba�ed on the approval of this
application
—'e4gW4Z /1 :2- -.
f E
Signature of Applicant Date
a e2ecl 2S T it961320117 Xdd 13rN3SUI dH wui:i7 : L it i oa ira i nr