MS-2015-00012.tif r
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CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
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l ica tion
(402) 426 -4195 - FAX
MS - 2015 -00012 a � ° "Ilse of www.blairnebraska.org
01/12/2015 bpeterse MISC Residential January 12, 2015 j
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° LOCATIONOFIMPROVEMENT: 758 S 16th St Unit 182, Blair, NE 68008
ARCHITECT:
GENERAL Paul Davis Systems, Inc.
OWNER: Housing Authority Of Blair CONTRACTOR:
3505 S 61stAve Cir
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758 S 16th St Omaha, NE 68106
BLAIR, NE 68008 -0000 j
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NATURE OF WORK STRUCTURE
Siding Primary
PROJECT NAME PERMIT EXPIRES 01/1112017
758S16thSt- 150112 - Siding ESTIMATED COMPLETION DATE 311/2015
DESCRIPTION OF WORK
Replace siding and sheet rock for fire repair
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: 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. j
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 j
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, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
aDDIcaion.
Date
Signature of pplicant
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