Application MS-2015-00886.tif CITYOF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
BuildingPermit Application (402)426-4191 -Phone
410/21120154jbeier:ma��MISC
.�� ,x (402)426-4195-FAX
°�„se °,a° www.blairnebraska.org
Residential October 21,2015
LOCATIONOFIMPROVEMENT: 1202 Colfax St, Blair, NE 68008
® ARCHITECT:
� GENERAL SELF
OWNER: Wesley D Fisher CONTRACTOR:
1202 Colfax St Blair, NE 68008
BLAIR,NE 68008-0000
EMSI
NATURE OF WORK STRUCTURE
primary residence
Storm Repair
PERMIT EXPIRES 10/20/2017
PROJECT NAME
1202CoIfaxSt-151021-storm damage ESTIMATED COMPLETION DATE 12/21/2015
DESCRIPTION OF WORK
siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
home owner
REScheck/COMcheck SUBMITTED: NA
-- DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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
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Sigr t re of Applicant Date