MS-2015-00858_0001.tif i
CITYOF BLAIR
218 S.16TH STREET j
BLAIR,NEBRASKA 68008
Building Permit Application (402)426-4191 -Phone
(402)426-4195-FAX
MS-2015-00858 Se o,Q� www.blairnebraska.org
10/08/2015 bpeterse MISC Residential October 8,2015
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LOCATIONOFIMPROVEMENT: 2916 Westridge Dr, Blair, NE 68008
ARCHITECT: GENERAL Berens Construction Inc
D OWNER: David C And Lana L Hiller CONTRACTOR:
428 Bryan Cir, Ste 200
2916 Westridge Dr GRETNA,NE 68028
BLAIR,NE 68008-0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
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PERMIT EXPIRES 10/07/2017
PROJECT NAME
2916WestridgeDr-151008-2014 Storm ESTIMATED COMPLETION DATE 12/31/2015
Damage
DESCRIPTION OF WORK
Re-siding with vinyl 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
Buildin fficial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
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Date
Signature of Applicant