MS-2014-02824_0001.tif CITYOF BLAIR
218 S.16TH STREET
BLAIR, NEBRASKA 68008
B uilding Pe rmit Application (402) 426 -4191 - Phone
MS- 2014 -02824 �% ' (402) 426 -4195 - FAX
'rise o+ a www.blaimebraska.org
09122/2014 ISC Residential September 22, 2014
LOCATIONOFIMPROVEMENT: 9615 Q Rd, Blair, NE 68008
ARCHITECT:
GENERAL Warrick Construction Co.
; OWNER. Keith A And Roberta Hightree CONTRACTOR:
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1114 James Dr
9615 Oak Valley Rd Blair, NE 68008
BLAIR, NE 68008 -0000
ELM ?:
NATURE OF WORK STRUCTURE
Storm Repair Primary Structure
PROJECT NAME PERMIT EXPIRES 09/21/2016
96150ak ValleyRd- 140922 -Storm Damage
2014 ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Vinyl siding replacement on north and west sides
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 act with or without the intention of the undersigned or any alteration or change from this application without approval of the
Bui ing Official, s a constitute sufficie t'�ound for the revocation of any permit issued which was based on the approval of
this ,application. r
Signature of Applicant ' bate
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