2506.tif i
I
:
CITYOF BLAIR I
218 S.16TH STREET I
BLAIR, NEBRASKA 68008
M - - Building Permit Application (402) 426 -4191 -Phone
MS- 2014 -02506 '6,.0� ud`��$ (402) 426 -4195 - FAX
Ise of a www.blairnebraska.org
08/2812014 MISC Residential August 28, 2014
LOCATIONOFIMPROVEMENT: 12214 Co Rd P26, Blair, NE 68008
ARCHITECT:
GENERAL Remodeling Dreams Construction
OWNER: Rosa M Clark CONTRACTOR:
19445 Bindsley Rd
12214 Co Rd P26 COUNCIL BLUFFS, IA 51503
BLAIR, NE 68008 -0000
�y
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/27/2016
12214Co Rd P26- 140828 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
a y r m> s
W
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 appr anal of the
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on t ap oval of this
pplication.
Dat
Signatur of Applicant
I
I
i