MS-2014-01130.tif l
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CITYOFBLAIR
{ r 218 S, t 6TH STREET
i BLAIR, NEBRASKA 68008
7 Building P Application (402) 426- 191 -Phone
{402) 426.4195 - FAX
M �F °n; `-�� °�'' www.blairnebraska.arg
07/10/ MISC J !Re!s!idential July 10, 2014
LOCATION OFIMPROVEMENT: 9923 Cord P35, Blair, NE 6800$
ARCHITECT:
GENERAL Hu Siding & Winnows, Inc.
OWNER: R andy A Jacobs CO NTRACTOR: 1406 Veter Dr
Elkhorn, NE 68022
9923 Co Rd P35
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT` EXPIRES 07109/2016
9923Cerd P35 - 140710 -2(}14 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Siding, roofing
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DEPOSIT PAID BY; SITE PLAN SU B MI TTED: NA
Contractor
REScheck /COMcheck 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. I
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system. I
4. The undersigned owner or a g ent understands and acknowledges this building g � g g 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
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fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Buildin Official, shall constitute sufficient ground for the revocation of any permit issued which inns based on the approval of this
ap
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Signa re of Applicant Date