MS-2015-00122.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
MS-2015-00122 ao (402) 426 -4195 - FAX
m or a www.blairnebraska.org
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03/10/2015 brwheele MISC Residential March 10, 2015
LOCATIONOFIMPROVEMENT: 150 S 11th St Unit 5, Blair, NE 68008
ARCHITECT: GENERAL SELF
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OV\NER: Marsha Ann Ruwe
CAr1oSJqCrdozq CONTRACTOR:
1417614 Co Rd Blair, NE 68008
BLAIR, NE 68008 -0000
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... NATURE OF WORK STRUCTURE
Siding Primary Structure
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PROJECT NAME PERMIT EXPIRES 0310912017
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150S11thSt- 150310 -2014 Storm Damage 12/31/2015
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Replace siding on mobile home
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Carlos Mendoza
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.
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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
application.
Signature of Applicant Date
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