ms-2015-00975.tif CITYOF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
Building PermitII I (402)426-4191 - Phone
(402)426-4195-FAX
MS-2015-00975 Ise of www.blairnebraska.org
12/01/2015 ShellyJ MISC Residential December 1,2015
LOCATION OF IMPROVEMENT: 2129 Park St, Blair, NE 68008
ARCHITECT: k
� GENERAL Home Science Solutions
a OWNER: Jacob J And Chelsea A Loftis CONTRACTOR:
1904 Washington St
2129 Park St Blair, NE 68008
BLAIR,NE 68008-0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 11/30/2017
2129ParkSt-151201-2014 Storm Damage ESTIMATED COMPLETION DATE 6/30/2016
DESCRIPTION OF WORK
Residing whole house
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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Signadre of'Applicant Date