MS-2014-02534.tif I
CITYOF BLAIR t
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone j
9 s "°
(402) 426 -4195 - FAX
MS- 2014 -02534 a � ° �hiS e of aJO\` www.blairnebraska.org
i
0910212014 Shelly) T 1 7 S 7C Residential September 2, 2014
d LOCATION OF IMPROVEMENT: 1254 South St, Blair, NE 68008
. ARCHITECT: GENERAL Nielsen Home Improvement
n OWNER: Rachel L Dannelly CONTRACTOR: j
1023 W Superior
1254 South St Missouri Valley, IA 51555
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 09/01/2016
1254SouthSt- 140902 -2014 Storm damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Reroof, siding and windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with with t the ion of the undersigned or any alteration or change from this application without approval of the
Buildin Offici , sh I'd ns ' ute sufficient ground for the revocation of any permit issued which was based on the approval of this
appli ation.
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Date
Sign ure of Apr icant