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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
- �" Building Permit Application (402) 426 -4191 - Phone
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(402) 426 -4195 - FAX
MS- 2014 -02201 ar ° Ise of ag www.blairnebraska.org
08115/2014 7 ISC Residential August 15, 2014
. LOCATION OF IMPROVEMENT: 2933 Westridge Dr, Blair, NE 68008
ARCHITECT: GENERAL Joe Goeden Construction
® OWNER: Kenneth E And Claudia J Johnson
CONTRACTOR:
1150 N 252nd St
2933 Westridge Dr WATERLOO, NE 68069
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08114/2016
2933WestridgeDr- 140815- 2014 Storm ESTIMATED COMPLETION DATE 12/31/2014
Damage
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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ININ W1
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
Buildina Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
ap icatio .
Signature of ,A plicant
l Date