ms-2015-406_0001.tif i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
i uilding Permit Application (402) 426 -4191 -Phone
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, (402) 426 -4195 -FAX
MS - 2015 - 00406 rse 01 a � www.blairnebraska.org
05120/2015 kathyl MISC Residential May 20, 2015
LOCATIONOFIMPROVEMENT: 2336 Fontanelle Blvd, Blair, NE 68008
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ARCHITECT: GENERAL Great American Siding LLC
5 OWNER: Dolly Anderson CONTRACTOR:
2719 Hickory St
2336 Fontanelle Blvd Omaha, NE 68105
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Primary Residence
Storm Repair
PERMIT EXPIRES 05/19/2017
PROJECT NAME
2336FontanelleBlvd- 150520 -2014 Storm ESTIMATED COMPLETION DATE 12/31/2015
Damage
DESCRIPTION OF WORK
Siding and some gutters and minor roofing work.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COM check SUBMITTED: 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 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
ppli ation.
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Dat
Sig ature of Applicant
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