MS-2015-00165_0001.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR\NEgRASMGuu0W
(402) 426-4191 - Phone
Building Permit Application
03/1912015 bpeters e tial March 20, 2016
uOCATIONDF|MPFmxsmEwT. 14608 Cord 22, Blair, NE 68008
ARCHITECT:
ocmsnm' Jorgensen Contracting, Inc.
cwvwsm Joseph A And Tammy JPeterson CONTRACTOR:
S3& Front 8t
22 14808CnRd Blair, NE 68008
BL#|R,0E 68008^0000
NATURE OF WORK STRUCTURE
Accessory Building
Storm Repair
PERMIT EXPIRES 03M912017
PROJECT NAME
14608Cord 22-150319-2014 Storm Damage ESTIMATED COMPLETION DATE 1213112016
DESCRIPTION OF WORK
Replace metal roof, west and north walls, cupola and 2 windows.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS:
BUILDING PLANS SUBMITTED. NA
1.Nu work will be started before a permit iu ISSUED AND POSTED.
2. For commercial permits, u set of plans for this project must ba submitted tu the Nebraska State Fire Marshal's Offioufor 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, Diu further understood that construction covered by this permit applicat shall not be commenced wnd| o
copy ofa 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 accordance with the codes/ordinances of the City of Blair and the State of Nebraska. Any omission oformisrepresentation of
fact with or without the intention of the d i ned or any a|byo$iun or change from this application without approval of the
fo the revocation of any permit issued which was based on the approval ofthis
a Ii
/:�/o�v� mrApou�un� Date