MS-2015-00164_0001.tif CITYOFBLAIR
218S.IGTHSTREET
BLA|R,NEBRASKA 68008
Building Permit Application (402) 4264191 - Phone
MS-2015-00164 ise at www.blairnebraska.org
o3/19/20is _______1bpeterse MISC Residential March 20, 2015
uOcxoowup|IMpnovsmswni3927 Co Rd 1 Blair, NE 68008
ARCHrrECT.
Gswsnm' Jorgensen Contracting, Inc.
cw»wsn: Robert VV And Janet Wallace-Gilliam Wallace oomnnwnon
530 Front St
13827 CmRdP1M Blair, NE 68000
BL&IR,0EW80$8-U000 -
IN ' �
F_ =0
NATURE OF WORK STRUCTURE
Storm Repair Accessory Building
PERMIT EXPIRES 0311912017
PROJECT NAME
13927Co Rd P18-160319-2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112015
DESCRIPTION OF WORK
Replace metal roof, west & north walls as needed, cupola, overhead door panels, I window and 2 screens.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1.Nn work VNbe started before opermit is ISSUED AND POSTED.
%. For oommenciml pmonUo, a set of plans for this project must be submitted to the Nebraska State Rno Marshal's Office for sm|mw.
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. |tiu further understood that construction ocmnmg hy this permit application shall not be commenced until
copy cfa permit signed by the Building Inspector isissued.
6. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in of Blair and the State of Nebraska. Any omission ofo,misrepresentation of
undersigne act wit or without the in W or any alteration or change from this application without approval of the
the revocation of any pannd iomoad which was based on the approval of this
appll 10
mmAppx,ao Date