MS-2014-01680_0001.tif i
CITYOF BLAIR
218 S. 16TH STREET
GLAIR, NEBRASKA 68008
®,. a... Building Permit Application (402) 426 -4191 -Phone
N.
(402) 426 -4195 - FAX
MS- 2014 -01680 1 0 n;s o+ Q°° www.blairnebraska.org
i
07128/2014 MISC Residential July 28, 2014
LOCATIONOFIMPROVEMENT: 2142 Front St, Blair, NE 68008
ARCHITECT:
GENERAL C & S Roofing Inc.
W OWNER: Dana J And Arlene J, Trustees Wolf CONTRACTOR:
2211 Peoples Rd Ste B
2038 Arbor Cir BELLEVUE, NE 68123
t BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/2712016
2142FrontSt- 140728 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
I
DESCRIPTION OF WORK
Roofing, gutters
I
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
i
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 /'Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Signature of Applicant Date