MS-2014-01468_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
._..��� Building Permit Application (402) 426 -4191- Phone
MS- 2014 -01468 a% . (402) 426 -4195 - FAX
/Se of a www.blairnebraska.org
07/2112014 MISC Residential July 21, 2014
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LOCATIONOFIMPROVEMENT: 1860 Nebraska St, Blair, NE 68008
ARCHITECT:
GENERAL A - 1 Home Restoration
® OWNER: Michael D Sturm CONTRACTOR: 4705 N 96 St
1 jt OMAHA, NE 68134
1860 Nebraska St
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME
PERMIT EXPIRES 0712012016
1860NebraskaSt- 140721 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
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DESCRIPTION OF WORK
Roof, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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. j
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 and rsigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accoryancF' wit ' the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of j
fact.
act with orfwi ut the intention of the undersigned or any alteration or change from this application without approval of the
Buldi g Of�cia , shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
p�a ,a
ignature of Applicant Date
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