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09-23-'14 13:52 FROM- Absolute Customs T -148 P0004/0006 F -062 j
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BLAIR, NEGRASKA68008
Oil IMI JU M B uilding P ermit Application (4 02) 48.410'1 - Phon e
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VI -2014 -02838 `Q „ Q , �,� °� www .blairnebraske.org
l9/2 =014 bpeterse MISC Residential September 23, 2014
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LOCATIONOPIMPROVEMENT: 1267 Jackson St, Blair, NE 68008
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ARCHITECT-1
G ENERAL Absolute Roofing
ti OWNED, Lori J Nielsen C XVMCTOR -.
17330 W Center Rd Ste 110
1267 Jackson St OMAHA, NE 68130
BLA,I NF, 680118 - 0000
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NATURE OF WORK S TRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 09/ 2112016
1367JaeksonSt- 140922- 201+4 Storm Damage ESTIMATED COMPLETION DATE 1=1/2014
DESCRIPTION OF WORK
Roofing, siding and windows.
DEPOSIT PAID BY: SITE ELAN SUBMITTED: NA
Contractor
REScheck=Mcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1. No worm 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 Stato Eire 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 Officia s h all constitu su nt ground for the revocation of any permit issued which was based on the approval of this
applicatio .
lgnat �p oant �� Date