3325.tif CTTYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68408
442 426 -4191 - Phone
Building cr i Application
A ` :. ; .:::.::.::.:...Q`\�aa (442) 426-4195. FAX
N1S�2 ®'14 x3325 'h Ise oa a� www.blairnebraska.org
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1210412014 bpeterse MISC Residential December 8, 2014
r�� l LOCATIONOFIMPROVEMENT: "141 N 21st St, Blair, NE 68008
ARCH[TECT:
GENERAL
Home Pride Contractors, Inc.
OWNER: Jeffrey O And Leanne Y Willis CONTRACTOR:
5202 "Q " St
= ° 141 N 21st St Omaha, NE 68117
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BLAIR, NE 68008 -4000
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NATURE OF WORD STRUCTURE
Storm Repair Primary Residence'
PROJECT NAME PERMIT EXPIRES 1210712016
141N21stSt- 141204-2014Starm Damage
ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
Re -roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecktCOMcheck 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
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 wi or without the intention of the undersigned or any alteration or change from this application without approval of the
Buildi g Official, shall itute sufficient ground for the revocation of any permit issued which was based on the approval of this j
appl' ation.
Signature a Ap cant Date