MS-2014-02385.tif C
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
402 426 -4191 - Phone
Building Permit Application
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(402) 426 -4195 - FAX j
MS- 2014 -02385 ar °�n of a� www.blairnebraska.org
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0812212014 MISC Residential August 22, 2014
LOCATIONORMPROVEMENT: 13976 Cord P18, Blair, NE 68008
ARCHITECT:
GENERAL Complete Industries Inc
OWNER: Leon D And Martha U Leishman CONTRACTOR:
1118 Applewood Dr
13976 Co Rd P18 PAPILLION, NE 68046
BLAIR, NE 68008 -5654
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/21/2016
13976Cord P18- 140822 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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
Building ici , s I constitute_ sufficient ground for the revocation of any permit issued which was based on the approval of this
applica n.
Signature of Applicant
Date