MS-2014-02028_0001.tif f
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 -FAX
MS -2014 -02028 Ise of a www.blairnebraska.org
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08111/2014 MISC Residential August 11, 2014
LOCATION OF IMPROVEMENT: 1250 Nebraska St, Blair, NE 68008
ARCHITECT:
GENERAL Performance Roofing & Sheet Metal Inc.
1 OWNER: Albert D And Velma, Etal Boyce CONTRACTOR:
15310 Jackson St
1250 Nebraska St OMAHA, NE 68154
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BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 0811012016
1250NebraskaSt- 140811 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roof, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
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Contractor
REScheck/COMcheckSUBMITTED: 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 accordance wi h the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or w' o t the intention of the undersigned or any alteration or change from this application without approval of the
Building Offici I, s 11--constitute 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 A plicant j