2745.tif CITY0FBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426-4191 - Phone
Building Permit Application
(402) 426-4195 - FAX
MS-2014-02745 ise ot www.blairnebraska.org
09/1612014 ntial September 16, 2014
W-0
LOCATION OFIMPROVEMENT: 421 N 23rd St, Blair, NE 68008
ARCHITECT:
GENERAL Contractors +
I R� OV\NER: Michael J And Nancy L Thompson CONTRACTOR:
4359 S 89 St
421 N 23rd St OMAHA, NE 68127
BLAIR, NE 68008-0000
............
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 09/15/2016
421 N23rdSt-1 40916-2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
20 MINN.--
0 111 500
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 ign d by the Building Inspector is issued.
" s ,
5.The undersigned ow er or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance ith t. e codes/ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
;I
fact with or hout he intention of the undersigned or any alteration or change from this application without approval of the
Building Offi i I sh constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
"
application.
pI
Signature of Ap t- Da(9