MS-2015-00229_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Buildin PermltA Application (402) 426 -4191 - Phone
9 v (402) 426 -4195 - FAX
MS- 2015 -00229 1 0 nse o, a� www.blairnebraska.org j
04/0712015 ShellyJ MISC 7777FResidential April 7, 2015
LOCATIONOFIMPROVEMENT: 1933 Soren Dr, Blair, NE 68008
ARCHITECT:
® GENERAL Riggs Roofing Co.
OWNER: Arnold D And Lois A Jensen CONTRACTOR:
3376 N 88th Plaza
1933 Soren Dr Omaha, NE 68134
BLAIR, NE 68008 -0000
na 101
NATURE OF WORK STRUCTURE
Storm Repair Primary
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PROJECT NAME PERMIT EXPIRES 04106/2017
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1933SorenDr- 150407 -2014 Storm Damage 12/31/2015
ESTIMATED COMPLETION DATE
I
DESCRIPTION OF WORK
Replace roof and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
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.
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.
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Signature of Applicant Date