3149.tif t
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008 E
Building er it Application (402) 426 -4191 - Phone
�� (402) 426 -4195 -FAX
MS- 2014 -03149 p��"�;se o a id``
www.blairnebraska.org
10/23/2014
1 1 intern MISC Residential October 23, 2014
LOCATIONOF IMPROVEMENT. 13361 Cord 16, Blair, NE 68008
ARCHITECT:
GENERAL Nastase Roofing
OWNER: Jim R, Etal Juul CONTRACTOR:
7610 N. 96th St
16 13361 Co Rd Omaha, NE 68134
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 10/22/2016
13361 Cord 16- 141023 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
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DESCRIPTION OF WORK
Roof
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 j
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
Buildi Officia hall con i e su ient ground for the revocation of any permit issued which was based on the approval of this
app ' tion
Signature of Applicant Date
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