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CITYOF BLAIR
�. 218 S. 16TH STREET
BLAIR, NEBRASKA 68008 I
Permit it Application (402) 426 -4191 -Phone
B uilding
(402) 426 -4195 - FAX
M S-2014-02024 Ise of ava www.blairnebraska.org
08/11/2014 intern MISC Residential August 11, 2014
LOCATION OF IMPROVEMENT: 1960 Grant St, Blair, NE 68008
ARCHITECT:
GENERAL Performance Roofing & Sheet Metal Inc.
® OWNER: Terry J And Natalie R Bellamy CONTRACTOR:
r 15310 Jackson St
4804 Hiland Dr OMAHA, NE 68154
�- -0000
BLAIR, NE 68008
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/10/2016
1960GrantSt- 140811 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESc heck/CO Mcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 'tho t intention of the undersigned or any alteration or change from this application without approval of the
Building Offi ial ` all onstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application, M
Signature o Applicant Date