MS-2014-02029_0001.tif i
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CITYOF BLAIR
p 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
II I I Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
S -2014 -02029 ;se of a \ff www.blairnebraska.org
SIR
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08/11/2014 MISC Residential August 11, 2014 I
LOCATION OF IMPROVEMENT: 1302 State St, Blair, NE 68008
ECT
ARCHIT:
u GENERAL Wise Choice
OWNER: Five J's Inc the CONTRACTOR:
6909 S 157 St A
_ 33 3400 Co Rd OMAHA, NE 68136
BLAIR, NE 68008 -0000
NATURE ®� W ® RK ST RUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/10/2016
1302StateSt- 140811 -2014 Storm Damage ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof, gutters, siding, windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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 accordan- with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact wifh`or ithout the intention of the undersigned or any alteration or change from this application without approval of the
Bu' ding 0, ci , shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
plicati '
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SignaluCof Ap licant Date
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