MS-2014-01653.tif CITYOFBLAIR
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218 S. 16TH STREET
BLAIR, NEBRASKA 68008 C
B uilding Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX I
MS -2014 - 01653 /se os o°° www.blairnebraska.org j
07/25/2014 MISC Residential July 25, 2014
LOCATION OF IMPROVEMENT: 1922 Butler St, Blair, NE 68008
ARCHITECT:
GENERAL Frank Gabby Siding & Windows
OWNER: Monte J And Bette J Cole CONTRACTOR:
P O Box 85
1922 Butler St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/2412016
1922ButlerSt- 140725 -2014 Storm Damage 12/31/2014 I
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RES check/CO Mcheck 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 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 j
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this r
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application.
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Signature of Applicant Date
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