MS-2014-02820.tif CITYOF BLAIR f
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
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S -2014 -02820 ° els e of a`� www.blairnebraska.org
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09/1912014 bpeterse MISC Residential September 22, 2014
�- LOCATIONOFIMPROVEMENT: 3030 Westridge Dr, Blair, NE 68008
' ARCHITECT:
GENERAL Quality Home Exteriors
v OWNER: Jeffrey And J Cynthia Smith CONTRACTOR:
y y 11679 Todd Dr
w 3030 Westridge Dr Blair, NE 68008
BLAIR, NE 68008 -1078
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 09/18/2016
3030WestridgeDr- 140919 -2014 Storm ESTIMATED COMPLETION DATE 12/31/2014
Damage
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DESCRIPTION OF WORK
Roof and Gutters.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
PN ,_
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 nt 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 withou he intention of the undersigned or any alteration or change from this application without approval of the
Buildin O cia s all constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appl' a
Date
Signature pfApplicant
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