MS-2014-01182_0001.tif CITYOF BLAIR
218 S. 16TH STREET
e, I
BLAIR, NEBRASKA 68008
P-? h ._�,° __ Building Permit Application (402) 426 -4181 -Phone
a�, (402) 426 -4195 - FAX
MS- 2014 -01182 t o /Se 01 qV www.blairnebraska.org
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07/1112014 MISC Residential July 11, 2014
�- LOCATIONOFIMPROVEMENT: 1645 S Hwy 30, Blair, NE 68008
y ARCHITECT. GENERAL Comp Exteriors
OWNER: Blair Theatres, Llc CONTRACTOR: 7805 L St
kr � OMAHA, NE 68127
1645 S Hwy 30
ter` BLAIR, NE 68008 -0000
� C y "r r
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 0711012016
1645SHwy 30- 140711 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
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DESCRIPTION OF WORK
Roof
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor i
REScheck1COMcheckSUBMITTED: 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.
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 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 was based on the approval of this
"Pi do
Date
Signature of Applicant
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