MS-2014-01214_0001.tif i
CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 -FAX
MS- 2014 -01214 ° hlse of qJO� www.blairnebraska.org
07/1412014 MISC Residential July 14, 2014
LOCATIONORMPROVEMENT: 2336 Jackson St, Blair, NE 68008
ARCHITECT: GENERAL TRI -State Construction
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. OWNER: Dennis L And Ruth A Trustees Mccormick CONTRACTOR: 7412 Meadow Ln
LaVista, NE 68128
2336 Jackson St
BLAIR, NE 68008 -0000
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M -a r t „r; r. »,. r4 ,' ; 413M
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 07/1312016
2336JacksonSt- 140714 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
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DESCRIPTION OF WORK
Re -roof, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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 intentio f the undersigned or any alteration or change from this application without approval of the L
Buil ' icial, s all constitute su icient ground for the revocation of any permit issued which was based on the approval of this
a lica '
Date
Signature of Applicant