MS-2015-00881_0001.tif CITYOFBLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
uil in Permit Application
(402)426-4191 -Phone
(402)426-4195-FAX j
MS-2015-00881 °�/se of a www.blairnebraska.org
10/19/2015 brwheele MISC 77Residential7ii October 19, 2015
LOCATIONOFIMPROVEMENT: 1227 Adams St, Blair, NE 68008
� ARCHITECT:
GENERAL Royalty Roofing
OWNER: John F And Helen M Hoer CONTRACTOR:
3519 N 53rd St
1227 Adams St OMAHA,NE 68104
BLAIR,NE 68008-0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PERMIT EXPIRES 10/18/2017
PROJECT NAME
1227AdamsSt-151019-2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2015
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DESCRIPTION OF WORK
Re-roof, gutters and siding.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
1:1 11111 possms
i
a e
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 des/ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or witho the i tention of the undersigned or any alteration or change from this application without approval of the
Buildin icial,shall co titute sufficient ground for the revocation of any permit issued which was based on the approval of this
appli atio
Signature of pplican Date