ms-2015-239_0001.tif j
erry ]F BLAIR
21 9g�g
/ BLAIR., ; 66908
1 (402) 426 4191 - Phone
s (402) 426.4196 FAX �
www.blairnebra ska.org
2015 -0023 Ell Emil I!
0410912015
DISC Residential April 9, 20'15
LpCATIONOFIMPROVEMENT: 1215 Jackson St, Blair, NE 68008
x ARCNrrECT: GENERAL Jorgensen Contracting, Inc.
OMER: Gerald P And Janet L Jorgensen CONTRACTOR: I
530 Front St
'1215 Jackson St Blair, NE 66006
LAIR, NE 6800$ -17000
R6
NATURE OF WORK STRUCTURE
b p
Small accessory building
Storm Repair
PERMIT EXPIRES 0410812017
PROJE NAME
121$JacksonSt- 150409 - Storm Damage ES TIMATED COMPLETION DATE 1213112015
DESCR
Replace roof, parts of west and north walls metal on small accessory building including cupola.
DEPOSIT PAID Sy;
SITE PLAN SUBMITTED., NA
Contractor
REScheckll✓OMciReck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED NA
i $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 o desdordinances of the City of Blair and the State of Nebraska. Any emission of or misrepresentation of
in with the lute ion th undersigned or any alteration or change from this application without approval of the
wilding O s const' Wsuffici t ground for the revocation of any permit issued which was based on the approval of this
applica '
Dare ll tt a rt re of Appli nt
i