MS-2014-03339_0001.tif I
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
uilding Permit Application (402) 426 -4191 -Phone
� roa (402) 426 -4195 - FAX
MS- 2014 -03339 ° else of www.blairnebraska.org
12/09/2014 intern MISC Residential December 11, 2014
i
LOCATIONOFIMPROVEMENT: 9477 Cord P35, Blair, NE 68008
==
ARCHITECT:
GENERAL Jorgensen Contracting, Inc.
® OWNER: Steven R And Carla J Andersen CONTRACTOR:
530 Front St
9477 Co Rd P35 Blair, NE 68008
BLAIR, NE 68008. -0000
I
NATURE OF WORK STRUCTURE
Storm Repair Accessory
PROJECT NAME PERMIT EXPIRES 12/10/2016
9477Cord P35- 141209 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
I
DESCRIPTION OF WORK
Roof, metal walls on Out Building
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
ffINJIMINE11111M 01111181M
r<
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
Bujld+n Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
_`applic
Date
�1&6ture of Applicant