ms-2015-277_0001.tif i
Ap r. 20. 2015 4; 41 PM No, 5$52 F. 1 j
CITYOFBLAIR
298 S.16TW STREET
,1 BLAIR, NEERA$KA68008
Buil Permit App (402) 426-4181 -Rhone
(402) 4264195 - FAX
MS-2015-00277 p '4r, rse a � q ��� www.blairnebraska.org
0412012015 MISC Residential April 20, 2015
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LOCATIONOFIMPROVEMENT; 234 Jackson St, Blair, NE 68008
` ARCNITI_CT:
e GENERAL Complete Industries Inc
■ OWNER: Michelle M And Kurt A Peterson CONTRACTOR:
$910 Washington Cir
234 Jackson St Omaha, NE 68127
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
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Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 04/19/2017
234JacksonSt- 150420 -2014 Storm Damage 1213112015
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Roof, gutters and siding.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecktCOMcheckSUBMITTED; 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.
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 Slate of Nebraska. Any omission of or rnisrepresenlation of
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the j
Building D icial, shall onstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicati
Signature of Applicant bad