2903.tif i
CITYOF BLAIR
218 S. 16TH STREET
i
BLAIR, NEBRASKA 68008
®� Building Permit Application (402) 426 -4191 - Phone
MS-201 ' � ���, (402) 426 -4195 -FAX
else of a www.blairnebraska.org
09/29/2014 ShellyJ MISC Residential September 29, 2014 1 1
LOCATIONOFIMPROVEMENT: 2008 Jackson St, Blair, NE 68008 4
ARCHITECT:
GENERAL Home Renovators, Inc.
OMER: Karmon R And Katrina L Standley CONTRACTOR:
ffi 503 Briarwood Dr
2008 Jackson St Yutan, NE 68073
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair . Primary
PROJECT NAME PERMIT EXPIRES 09/28/2016
2008JacksonSt- 140929 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Reroof, gutters and siding replaced on North side only
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck 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 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, hall nstit sufficient ground for the revocation of any permit issued which was based on the approval of this
appl'cpf
J� f
Date
Signature of Applicant