3232.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application
11104/2014 intern MISC, Residential November5,2014
LOCA 1334 Prospect Ave, Blair, NE 68008
OWNER: Steven L And Kristi L Rounds CONTRACTOR
164 S Ist St
1334 Prospect Ave Blair, NE 68008
BLAIR, NE 68008-0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 11/04/2016
1334ProspectAve-1 41104-2014 Storm ESTIMATED COMPLETION DATE 12/31/2014
Damage
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESc heck/COM check SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1.No work will be started before o permit ha ISSUED AND POSTED.
2. For commercial permits, o 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 eppUooUnn does not constitute |moumnoe of
this building penn|i hia further understood that construction covered by this permit application shall not bocommenced until o
copy of 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 met forth above and
in accordance with the codes/ordinances of the Qh/ of Blair and the State of Nebraska. Any nm|ao|on 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 Ml \ , shall constitute sufficient d for the revocation of any permit issued which was based on the approval of this
ap
Date