2836.tif 09-23-114 13:52 FROM-Absolute Customs T-148 P0005/0006 F-062
icioa. tuinoinrpL-1
BLAIR,NEBRASKA68008
B Permit Application (402) 426-4191 - MOM
Z4 (402) 426-4105 - FAX
VISm2014-02836 r�m� 01 www.blalrnabraska.org
19/22/2014 bpeterse MISC Residential September 23, 2014
=ATIONOFIMPROVEMENT 1053 James Dr. Blair, NE 68008
ARCHnTECT- GENERAL Absolute Roofing
OWNER: Connie L Andersen OONTRAMFI;
17330 W Center Rd Ste 110
1053 James Or OMAHA, NE 68130
GLAIR, NE 68008-0000
. . . . . . . . . . . ......
. . . . . . . . . . . . . .
ECTED CHARACTIEISTit
R a OF
.. ......... .
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 09121/2016
1053JamesDr-140922-2014 Storm Damage ESTIMATED COMPLETION DATIE 1V31/2014
DESCRIPTION OF WORK
Roofing, Gutters and Windows.
01�110$11T PAID HY; SITE PLAN SUBMITTED: NA
Contractor
REScheek/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
INN
1. No work will be started before a permit is ISSUM 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 re for electrical, plumbing, heating, ventilatin and air conditioning, and septic s
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this buildin permit. It is further understood that construction covered b 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 Official, sh 11 constitute suffic' nt ground for the revocation of any permit issued which was based on the approval of this
application,
4
alit Dat
PH ant
t�p