MS-2014-02533.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426-4191 - Phone
Building Permit Application
(402) 426-4196 - FAX
MS-2014-02533 0 Ise ot www.blairnebraska.org
Shelly MISC Residential September 2, 2014
2014
LOCATION OFIMPROVEMENT: 866 N I Ith St, Blair, NE 68008
ARCHITECT GENERAL Nielsen Home Improvement
CONTRACTOR:
OVVNER: Debra J Wenz
1023 W Superior
Missouri Valley, IA 51555
866 N 1 Ith St
BLAIR, NE 68008-0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 09/01/2016
866NI I thSt-1 40902-2014 Storm damage ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Reroof, siding and windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheckICOMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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,®riftli out th"' tention of the undersigned or any alteration or change from this application without approval of the
Buildinvffici s c9dstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applic I ation./
Si p��icant Date