2172.tif i
I
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 - Phone
MS -2014 -02172 O'o�, Jo`\�� (402) 426 -4195 -FAX
/se ot a www.blairnebraska.org
[ 0::8 : /:1:4:/2014 ShellyJ MISC Residential August 14, 2014
LOCATIONOFIMPROVEMENT: 163 N 25th St, Blair, NE 68008
ARCHITECT:
GENERAL SELF
OWNER: Sheets, Berniece Living Trust CONTRACTOR:
163 N 25th St Blair, NE 68008
BLAIR, NE 68008 -0000
r
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/13/2016
163N25thSt- 140814 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Re roofing and siding for house and two garages.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
v _ f
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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
pplication.
Si ature of Applicant
to
i
I
t v
r t
_ I
CITY Of I)LAIQ
ris o f a
ROOF PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and /or roofing permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2009 International Building
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your roofing permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
I have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the owner /contractor for this project.
f
Owner /Occupant ontractor
City of Blair to
i
EDUALNOUSINU
218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cifyofblair @ci.blair,ne,us OPPONTUNITY
I