MS-2014-01079_0001.tif CITYOF BLAIR
218 S. 16TH STREET
,1 BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS- 2014 -01079 b ' °m;s °, www.blairnebraska.org
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07/10/2014 MISC Residential July 10, 2014
LOCATIONOFIMPROVEMENT: 9325 Hwy 133, Blair, NE 68008
ARCHITECT:
GENERAL Papillion Windows & Siding
OWNER: Gordon W And Beverly J Soderberg CONTRACTOR: 1230 Royal Dr Ste 2
PAPILLION, NE 68046
133 9325 State Hwy
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07109/2016
9325Hwy 133 - 140710 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Shingles, gutters, siding
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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 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
f 90 with or without the intention of the undersigned or any alteration or change from this application without approval of the
Idling Official, s �i constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
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Signs re of Applicant Date
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