MS-2014-01470_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
(402) 426 -4196 - FAX
MS -2014 -01470 ise of Q�d\\ www.blairnebraska.org
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0712112014 MISC Residential July 21, 2014
LOCATIONOFIMPROVEMENT: 2716 Sunrise Dr, Blair, NE 68008
ARCHITECT:
®' GENERAL A - 1 Home Restoration
CONTRACTOR:
OWNER: Marshall O And Lynda L Nelson 4705 N 96 St
OMAHA, NE 68134
.: 2716 Sunrise Dr
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 0712012016
2716Sun rise Dr- 140721 -2014 Storm Damage ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Roof, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
i
Contractor
REScheck/COM check SUBMITTED: NA j
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 the intention of the undersigned or any alteration or change from this application without approval of the
Building fficia� V shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app/ ata n. '
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Signature of Applicant Date