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CITYOF13lAIR �
248 S.16TH STREET
13LAIR, NEBRASKA 68008
= Building Permit Application (402) 426 -4191 - Phone
�r ,.�►' (402) 426 -4195 - FA,X
MS► 'i -0 $44 °arse 01 a�'` www.blairnebraska.org
1010212844 intern MISG Residential October 6, 2014
LOCATiONOFIMPROV9V12N - r - 1328 Nebraska St, Blair, NE 68008
� ,ARCHITECT '
Gam- Husker Rooting, Biding Gutters
a OWNER Brian R And Wendy S Lundgren rM=R:
9001 Arbor fit
1328 Nebraska St OMAHA,, NE +68124
GLAIR, NE 68008 -0000
OREM
NATUR OF WORK TRUD TDRE
Storm Repair primary Residence
PROJ DAME PERMIT EXPIRES 10/01/2016
1328NebrskeSt- 141802 - 201 • St orm damage ESTIMATED COMPLETION GATE 12/3112014
DE8CRIPTION OF WORK
Roof, siding, gutters
DEPOSIT PA BY: SITE FLAN SUB MITTED: NA
Contractor
RESchecIdCOMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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 Star Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and sir 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 cornered by this permit appliegon 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 codeslordinanoes 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 Offciai, shall constitute sufficient ground for the revocation of any permit Issued which was based on the approval of this
a
Signature of Applicant Data