MS-2014-02026_0001.tif I
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CITYOF BLAIR
218 S. 16TH STREET
M BLAIR, NEBRASKA 68008
m 402 426 -4191 - Phone
Building 't Itc tin ( )
(402) 426 -4195 - FAX
MS- 2014 -02026 br ° M/Se Of aJ www.blairnebraska.org j
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0811112014
7
MISC Residential August 11, 2014
wr LOCATION OF IMPROVEMENT: 1755 Nebraska St, Blair, NE 68008
ARCHITECT:
GENERAL Performance Roofing & Sheet Metal Inc.
OWNER: Terry J And Natalie R Bellamy CONTRACTOR:
15310 Jackson St
� 4804 Hiland Dr
OMAHA, NE 68154
s BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/1012016
1755NebraskaSt- 140811 -2014 Storm Damage ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
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Roof, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck 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. i
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 o er or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance wi t e codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or wit ou intention of the undersigned or any alteration or change from this application without approval of the iL
B uilding Offici all c stitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
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Date
Signature of plica
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