MS-2014-01642.tif i
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
a ^ - 402 426 -4191 - Phone f
Building Permit Appl ica tion c
(402) 426 -4195 - FAX
MS2014 - 0'1 642 �'`��, S� Q a�y� www.blairnebraska.org
0712512014
MISC Residential July 25, 2014
LOCATIONOFIMPROVEMENT; 880 Pheasant Cir, Blair, NE 68008
ARCHITECT; GENERAL A n thony Company Builders LLC
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OWNER: Clinton W And Rebecca L Williams
C ONTRACTOR:
' 19262 Walnut St
155 S 25 #h St OMAHA, NE 60130
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary 'Residence
PROJECT NAME PERMIT EXPIRES 0712412016
880PheasantC! 140726 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31120/4
DESCRIPTION OF WORK
Reif, siding, gutters, garage
DEPOSIT PA ID BY: SITE PLAN SUBMITTED. NA
Contractor
REScheck/COMcheck SUBMITTED: CIA
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 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.
a. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codesfordinances 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 co e sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Date
Slg4 Lure of Applicant
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