3045.tif i
CITYOF BLAIR
218 S.16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS- 2014 -03045
p /se of a� www.blairnebraska.org
10/14/2014 MISC Residential October 14, 2014
k LOCATIONOFIMPROVEMENT: 1125 Nebraska St, Blair, NE 68008
ARCHITECT:
GENERAL Hicks Drywall LLC
k OWNER: Harry A Drummond CONTRACTOR:
PO Box 44
160 Pinyon Cir Blair, NE 68008
PINEHURST, NC 28374 -9466
Pa l
NATURE OF WORK STRUCTURE
Roofing /Soffit/Eaves /Gutters Primary Structure
PROJECT NAME PERMIT EXPIRES 10/13/2016
1125NebraskaSt- 141014 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1013112014
DESCRIPTION OF WORK
Roof street side of house and garage
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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
Budding O icial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application� j
Signature of Applicant Date