MS-2015-00333_0001 (2).tif i
CITYOF BLAIR
» P 218 S. 16TH STREET
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BLAIR, NEBRASKA 68008
Building Permit Application (402)426 -4191 -Phone
(402) 426 -4195 - FAX
MS- 2015 -00333 ' ° mse °, www.blairnebraska.org
04/30/2015 Shelly) MISC Residential April 30, 2015
LOCATIONOFIMPROVEMENT: 2336 Jackson St, Blair, NE 68008
ARCHITECT: GENERAL Pride Siding & Seamless Gutters Inc.
OWNER: Dennis L And Ruth A Trustees Mccormick CONTRACTOR:
.' 1006 Grandview Ave
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2336 Jackson St BELLEVUE, NE 68005
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence j
PROJECT NAME PERMIT EXPIRES 04129/2017
2336JacksonSt- 150430 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2015
DESCRIPTION OF WORK
Siding and gutters.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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 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
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Signatu e W Applicant Date