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CITYOF BLAIR
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218 S.16TH STREET
BLAIR,NEBRASKA 68008
Building
Application (402)426-4191 - Phone
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MS-2015-00962 .o,��se of qo www.blairnebraska.org
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11/20/2015 Shelly) M ISC Commercial November 20,2015 j
LOCATIONOFIMPROVEMENT: 284 N 16th St, Blair, NE 68008
ARCHITECT:
GENERAL Jorgensen Contracting, Inc.
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OWNER: Se Smith and Sons Lumber Co CONTRACTOR:
y 530 Front St
1680 Frnt St Blair, NE 68008
BLAIR,NE 68008-0000
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NATURE OF WORK STRUCTURE
Sub-Work New Const SE Smith
PROJECT NAME PERMIT EXPIRE 11/19/2017
284N16thSt-150720-Remodel 11/20/2015
ESTIMATED COMPLETIONDATE
DESCRIPTION OF WORK
Remodeling/Repairing damaged wall- Wall was hit by vehicle.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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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
Building Official, shall constitute_BjXlfficient grou f r the revocation of any permit issued which was based on the approval of this
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Date
iWure of Applicant
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