MS-2015-00178_0001.tif i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B ° C
m Building Permit Application
MC (402) 4zs -4191 -Phone
MS- 2015 -00178 �O�o (402) 426 -4195 - FAX
�+rse of a www.blairnebraska.org
03/19/2015 77bpeterse MISC Residential March 20, 2015
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LOCATIONORMPROVEMENT: 8661 Victory Ln, Blair, NE 68008
ARCHITECT:
GENERAL Jorgensen Contracting, Inc.
OWNER: Cathy JO Lee CONTRACTOR:
530 Front St
8661 Victory Ln Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Accessory Building
PROJECT NAME PERMIT EXPIRES 03119/2017
8661VictoryLn- 150319 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112015
DESCRIPTION OF WORK
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Replace roof, west and north wall metal, west walk door, cupola and all non matching metal trim and gutters, i
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
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Contractor
REScheck/COMcheck 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
Bui ' Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
pplic io
ture of Applica Date