2531.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 - Phone
. (402) 426 -4195 - FAX
MS- 2014 -02531 °Ise of a� www.blairnebraska.org
09/02/2014 =MISC Residential September 2, 2014
LOCATION OF IMPROVEMENT: 1031 Park St, Blair, NE 68008
ARCHITECT:
GENERAL Jorgensen Contracting, Inc.
OWNER: Karene Brenton And Raymond R Ryan CONTRACTOR:
530 Front St
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1031 Park St Blair, NE 68008
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BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME
PERMIT EXPIRES 09/0112016
1031 ParkSt- 140902 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Replace roof and gutters on metal pole building garage
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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
ith or without the in i-o of the undersigne any alteration or change from this application without approval of the
x Build fficial, shall nstitute su icient ground r t he revocation of any permit issued which was based on the approval of this
f ap
S' nature of Applicant Date