MS-2014-01405_0001.tif 55
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
MS- 2014 -01405 Q (402) 426 -4195 -FAX
'Nse of a www.blairnebraska.org
07/18/2014 MISC Residential July 18, 2014
r LOCATIONOFIMPRO�ENIkNT: 821 N 16th St, Blair, NE 68008
ARCHITECT: ' GENERAL Roof Brigade
F OWNER: Jamie ,'teffQn CONTRACTOR: 14015 Meredith Cir
OMAHA, NE 68164
821 R'16t1h St'
BLAIIR, "68008 -0000
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NATURE OF WORK'S STRUCTURE
Storm Repair
Primary Residence
PROJECT NAME
PERMIT EXPIRES 07/17/2016
821N16thSt- 14071 2614 Storm Damage ESTIMATED COMPLETION DATE
12/31/2014
DESCRIPTION OO WORK
Roof, siding
DEPOSIT PAID BY ' SITE PLAN SUBMITTED: NA
Contractor '
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS BUILDING PLANS SUBMITTED: NA
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1. No work will be startod` before a permit is ISSUED AND POSTED.
2. For commercial pdr"i its,' a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits qre, r quired for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned,owrter agent understands and acknowledges this building permit application does not constitute issuance of
this building permit Ji by the Building Inspector is issued.
]s further understood that construction covered by this permit application shall not be commenced until a
copy of a permit sipped
5. The undersigned ovm' e`r or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance wit} tl16 /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, 04 Gonstitute sufficient ground for the revocation of any permit issued which was based on the approval f this
application. ,✓"
Signature of Applicant Dat
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