MS-2014-03276.tif 11-11-'14 13:37 FROM- Absolute Customs T -239 P0001/001211 F -330
CITYOFBLAIR
218 S.15TH STREET
_
BLAIR, NEBRASKA 60008
B u ild ing er i A pplication (402) 425 -4191 - Phone
MS- 2014 -03276 �rQ u (402) 429.4195 - FAX I
1$ of a www.blairnabraske.org C
E
11/1012014 intern MISc Residential November 11, 2014
i
LOCATIONOFIMPROVEMENT'; 30120 Westridge Dr, Blair, NE 88008
4 ARCH(TEaT;
GENERAL Absolute Roofing
1 : OVMER: Richard P And Julio A [sham CONTRACTOR:
17330 W Conter Rd Ste 110 C
3020 Westrldge Dr OMAHA, NE 68130
BL.AIR, NE 68008 -00010
M=17 = � � o
NAT URE OF WORK r.bS' 7�TrE
Storm Repair Primary Residence
PROJECT NAME PE RMIT EXPIR 11/10/2016
3020Wesi 141110 -2014 St orm
Damage ESTI MATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Roof, siding, windows
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 Offic I, shall constit t sufficient ground for the revocation of any permit issued which was based on the approval of this
applicatio
Sign 6t f Applicant Dite
i