MS-2014-02341.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone j
(402) 426 -4195 - FAX
4 -02341 ;Se °,
p ' ° ° www.blairnebraska.org f
MS- 201 n, a
1
E 08120/2014 TM ISC Residential August 20, 2014
LOCATION OF IMPROVEMENT: 1417 Fieldcrest Dr, Blair, NE 68008
ARCHITECT:
® GENERAL Infinity Roofing & Siding, Inc.
OWNER: Ashley L Frederick CONTRACTOR:
10685 Bedford Ave Ste 300
9348 Co Rd P35 OMAHA, NE 68154
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/1912016
1417FieldcrestDr- 140820- 2014 Storm ESTIMATED COMPLETION DATE 12/31/2014
Damage
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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 any alteration or change from this application without approval of the
Building Official, shall consfitu sufficient grou f he revocation of any permit issued which was based on the ap roval of this
application.
Date
Signature of Applicant