MS-2015-00619.tif i
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS -2015-00619 11
is of a www.blairnebraska.org
07/30/2015 ShellyJ MISC Residential July 30, 2015
LOCATION OF IMPROVEMENT: 321 E Baronage Dr, Blair, NE 68008
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ARCHITECT: GENERAL Nielsen Home Improvement
OWNER: Steve A And Marcya L Tierney CONTRACTOR:
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1023 W Superior
321 E Baronage Dr Missouri Valley, IA 51555
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PE RMIT EXPIRES 07/29/2017
321 EBaronageDr- 150730 -2014 Storm ES TIMATED COMPLETION DATE 12/3112015
Damage
DESCRIPTI OF WORK
Replace roof and siding
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 w' ut ee. tion of the undersigned or any alteration or change from this application without approval of the
Building icial, cons ' ute sufficient ground for the revocation of any permit issued which was based on the approval of this
applic ion.
Date
Signature of Applicant