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CITYOF BLAIR
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218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Perm (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS- 201 se of aJa\`� www.blairnebraska.org
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08/11/2014 MISC Residential August 11, 2014 I
A LOCATION OF IMPROVEMENT: 1453 Grant St, Blair, NE 68008
ARCHITECT:
GENERAL Quality Home Exteriors
OWNER: Darryl B And Sandra L Paulsen CONTRACTOR:
11679 Todd Dr
1453 Grant St Blair, NE 68008
�F BLAIR,NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair
Primary Residence
PROJECT NAME PERMIT EXPIRES
08/10/2016
1453GrantSt- 140811 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof, siding, gutters, windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor E
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
IAN
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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
Buildin , s II constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
Date
Sign of Applicant