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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 - Phone
MS- 21 4 -�� 983 ago (402) 426 -4195 -FAX j
'��Se of a www.blairnebraska.org I
08/08/2014 7 7SC 77 Residential August 8, 2014
LOCATIONOFIMPROVEMENT: 2175 Davis Dr, Blair, NE 68008
N ARCHITECT:
GENERAL Triton Exterior
OWNER: Helen And Louise Pfeiffer CONTRACTOR:
1625 N 203rd St
245 S 22nd St Apt 224 ELKHORN, NE 68022
BLAIR, NE 68008 -1811
MEN- ME-
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/07/2016
2175 Davis Dr- 140808 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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 without the intention of the undersigned or any alteration or change from this application without approval of the j
Buil.0h fficial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a on.
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Signature of 4 licant
Date
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