2860.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
-4191 Phone
(402)426
Building Permit Application
(402) 426-4195 - FAX
MS-2014-02860 140
ise 01 www.blairnebraska.org
rbpeterse MISC Residential Septemb
09/2412014
LOCATIONOF IMPROVEMENT: 2105 Nebraska St, Blair, NE 68008
ARCHITECT:
GENERAL 123 Exteriors
CONTRACTOR:
OV\NER: Karen K Bohl
7185 N 50th St
2015 Nebraska St Omaha, NE 68152
BLAIR, NE 68008-0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 09/24/2016
2105NebraskaSt-140924-2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Install/Replace 17.67 Squares of roofing material and gutter.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
NOW, ANN
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 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, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a li
n.
Signature of Applicant Date