MS-2014-01404_0001.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 -4191 -Phone
(402) 426 -4195 - FAX
MS- 2014 - 01404 p e of a www. blairnebraska.org
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07/18/2014
MISC Residential July 18, 2014
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a ' LOCATIONOFIMORO'VE MENT: 734 S 21st St, Blair, NE 68008
" ARCHITECT:
GENERAL Roof Brigade
owNER: phylh EStricklett CONTRACTOR: 14015 Meredith Cir
` ,x OMAHA, NE 68164
734 S 21st`St
BLAfR;_ 9E,, -0000
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NATURE OF WO RK STRUCTURE
Storm Repair
Primary Residence
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f PERMIT EXPIRES 07/17/2016
PROJECT NAMI�
734S21stst- 140718 x 2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014 1
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DESCRIPTION ORWORK
Roof, siding'
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DEPOSIT PAID BY, SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS!,, .8r BUILDING PLANS SUBMITTED: NA
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1. No work will be started: before a permit is ISSUED AND POSTED.
2. For commercial perm 6,'a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
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3. Separate permit, are' required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned oWb,6r''or agent understands and acknowledges this building permit application does not constitute issuance of
this building perrrht;° IYis further understood that construction covered by this permit application shall not be commenced until a
copy of a permit sigoed by the Building Inspector is issued.
5. The undersigned gWner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance wit's he; °codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or withg4,`; intention of the undersigned or any alteration or change from this application without approval of the
Building Official, shalt constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicati . �
Date
Signature of Applicant