MS-2014-01900.tif i
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CITYOFBLAIR I
218 S.16TH STREET
s BLAIR, NEBRASKA 68008
{ r • (402) 426 -4191 - Phone
(40z) 426.4195 - FAX
MS- 2014 -01900 www.b[airnebraska.org
08/04/2014 I ShellyJ MISC Residential August 4, 2014
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L.00A11ONOFIMPROVEMENT 1740 Nebraska St, Blair, NE 68008
ARCHITECT:
GENEF2At. Titan Exteriors
OWNER Jeffrey E Carroll CONTRACTOR
804 S Beadle St
2009 N 153rd Ave PAPILLION, NE 68046
OMAHA, NE 68 -0000
_ � .r ; ,} l i v P £;': x� � {' t! £ ? i .,x .� �=5 -. X I .,, ,'� ,: � : k � , .� _ � i �£ } � ut :y j• i
NATURE OF WORK STRUCTURE
Storm repair Primary
PROJECT NAME PERMIT EXPIRES 08/03/2016
1740NebraskaSt- 140804 -2014 Storm Damage 12!31/2014
ESTIMATED C�}MRLETI�J,N DATA
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DESCRIPTION OF WORK
Reroof, siding and windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REZ1 ' n►eck=4tdl, cfteck SUBM1'S E13: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50 ,
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.
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
appli ion .
rlkl 2,
Date
sig ure of Applicant
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