MS-2015-00607_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS -2015-00607 p 'C'Ws e of www.blairnebraska.org
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07/27/2015 ShellyJ MISC Commercial July 27, 2015
..` LOCATIONOFIMPROVEMENT: 524 S 10th St, Blair, NE 68008
ARCHITECT:
®- GENERAL Jensen Lawn Solutions
OWNER: Jensen Lawn Solutions, Inc CONTRACTOR:
524 S 10th St
716 N 11th St Blair, NE 68008
;- BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/26/2017
524S10thSt- 150727 -Storm Damage 12/31/2015
ESTIMATED COMPLETION DATE
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DESCRIPTION OF WORK
Roof and Siding - Metal
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. T e undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
i accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
t ct'`with or w' ut the intention of the undersigned or any alteration or change from this application without approval of the
uildl Offici I, all consti ute sufficient ground for the revocation of any permit issued which was based on the approval of this
pplic ti If
r l I
Date
SignarAPPI14t