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MS-2014-01739_0001.tif i i CITY0FBLAIR I 21 B B;16TH STREET BLAllit, NEBRASKA 68008 wilding Permit Application (402)`26 -0'191 -Phone MS - 2014 .01739 l �``� (402) 26 -4 186 - FAX amt www. lairnebraska.org 07!2912014 MISC Residential July 29, 2014 LOCATIONOFIMPROVEMENT: 12936 Cord P26, Blair, NE 66008 ARCHITECT. 1 GENERAL Hometown Roofing, In OWNER: Pattianne Belitz CONTRACTOR: t 13318 Millard Ave 1 12936 Co Rd P26 Omaha, NE 68137 BLAIR, NE 68008 -0000 NATURE OF WORK STRUCTURE Storm Repair Primary Residence I PROJECT NAME PERMIT EXPIRES 07/2812016 12936Card P26 - 140729 -2014 Storm Damage � ESTIMATED COMPLETION DATE 1:1131/2014 DESCRIPTION OF WORK Roof i I DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA Contractor REScheck/COMcheck SUBMITTED: NA 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 Ma7nconstitute (office for review. � 3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septiem. 4, The undersigned owner or agent understands and acknowledges this building permit application does Issuance of this building permit. It is further understood that construction covered by this permit application shall no 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 codesiordinances 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, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this application. Signature of Applicant Dide T aged aS T tr96BZ©ir XU-1 13CM3S1J dH WIJSE : L 1I T ©a DE Inc I