1885.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Per i Application (402) 426 -4191 - Phone
(402) 426 -4195 -FAX
MS -20'14 -01885 p` ° Is e of a� ° �� www.blairnebraska.org
1 111 1 11 11111111 ME
MM 7 08/04/2014 MISC Residential August 4, 2014
v� LOCATION OF IMPROVEMENT: 1112 Sunrise Dr, Blair, NE 68008
ARCHITECT:
® GENERAL Goslin Contracting Inc.
OWNER: David B Schroeder CONTRACTOR:
6116 Military Ave
1112 Sunrise Dr OMAHA, NE 68104
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 08/0312016
1112Sun rise Dr- 140804 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Reroof house and shed
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COM check SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
a:
YEN MIAMI W-M-0
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
application.
Date
Signature of Applicant