MS-2014-01074_0001.tif i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
� ® ,,, Vl °` Building Permit Application (402) 426 -4191 -Phone 11
MS- 2014 -01074 410` �� (402) 426 -4195 - FAX
/se o+ a www.blairnebraska.org
07/10/2014 MISC Residential July 10, 2014
LOCATIONOFIMPROVEMENT: 725 N 10th Ave, Blair, NE 68008
ARCHITECT: GENERAL Royalty Roofing
OWNER: Jill Autenrieth CONTRACTOR: 3519 N 53rd St
OMAHA, NE 68104
725 N 10th Ave
' BLAIR, NE 68008 -1339
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/09/2016
725N10thAve- 140710 -2014 Storm Damage ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof, siding, gutters, paint
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.
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 ithout the intention of the undersigned or any alteration or change from this application without approval of the
B . c g 0, icial, shall co it to sufficient ground for the revocation of any permit issued which was based on the approval of this
app is ti
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Signature of Applicant Date