MS-2015-00168_0001.tif i
CITYOFBLAIR
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218S.16THSTREET ;
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
- B uilding Permit A,plicion
(402) 426 -4195 -FAX
MS -2015 -00168 °�J :e of a ° www.blaimebraska.org
0311912015 bpeterse =SC Residential March 20, 2015
LOCATIONOFIMPROVEMENT: 10448 Cord 29, Blair, NE 68008
c ARCHITECT. j
®- GENERAL Jorgensen Contracting, Inc.
OWNER: Ruiz, Robert Revocable Trust CONTRACTOR:
530 Front St
2910448 Co Rd Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Accessory Building
PROJECT NAME PERMIT EXPIRES 03/19/2017
10448Cord 29- 150319 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2015
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DESCRIPTION OF WORK j
Replace metal roofs, north, west east walls of horsebarn and metal roof north and west wall of 4 car garage, 9
accessories i.e. walk doors, vents, gutters.
DEPOSIT PAID BY: SITE PLAN SUBMITTED. NA 1
Contractor
RESchecklCOMcheckSUBMITTED. 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 i
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
i din Official, sha on tute ient ground for the revocation of any permit issued which was based on the approval of this
appii
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i ature of Applicant Date
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