1857 South Application.tif i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
Building Permit Application
(402) 426 -4195 - FAX
MS -2014 -01406 / 01 OP www.blairnebraska.org
07/18/2014 MISC Residential July 18, 2014
LOCATIONOFIMPROVEMENT: 1857 South St, Blair, NE 68008
ARCHITECT:
GENERAL D K Construction
OWNER: David And Robin Young CONTRACTOR: 8102 Maple St
L ' OMAHA, NE 68134
40 12881 Co Rd
BENNINGTON, NE 68007 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 07/1712016
1857SouthSt- 140718 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roof, siding, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
INS
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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
Building Official, s all constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Date
Signature of Applicant