MS-2014-01674.tif I
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CITYOF GLAIR
� 218 S.1 STH STREET k
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BLAIR, NEBRASKA 68008
Building Permit Application c4o2} 26.4191 - Phene
(402) i 26.11195 - FAX
MS 2014 - 0167 "�° ,�,a www, Iairnobraska.org
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07/26/2014 MISC Residential July 25, 2014
LCCATIONOFIMPROVEMENT: 11336 Rambler Dr, Blair, NE 68008
e ARCHrrECT: GENERAL Hometown Roofing, In6.
OMER: Gregory J And Roxanne Halamek
CONTRACTOR:
13316 Millard Ave
11336 Rambleridge Or Omaha, NE ' 68137
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/2412016
11336RambleridgeOr- 140725 -2014 Storm ESTIMATED CO PLETION DATE
Damage 1;213112014
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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♦ A n M •
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. j
5. The undersigned owner or agent agrees to perform the proposed work in accordance with the specificitions 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 I
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
application.
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Signature of pplicant Date
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