MS-2010-00093_0001.tif i
CITY OF BLAIR
218 S. 16TH STREET
_ BLAIR, NEBRASKA 68008
B uilding P ermit Application (402)4264191 -Phone
(402) 426 -4195 - FAX
MS- 2010 -00093 „s@ o{ a� ° www.blairnebraska.org
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09/01/2010 MISC Residential September 1,
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LOCATIONOFIMPROVEMENT: 12475 Ann Dr, Blair, NE 68008
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ARCHITECT:
GENERAL
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Kinns Roofi � a OWNER: Penny Bradford CONTRACTOR: Mc g & Sheet Metal
„I 164 S 1st St
12476 Ann Dr Blair, NE 68008
Blair, NE .68008
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NATURE OF WORK PROPOSED USE
Roofing /Soffit/Eaves /Gutters Primary Residence
PROJECT NAME PERMIT EXPIRES 08/31/2012
12475AnnDr- 00901 -Roofing ESTIMATED COMPLETION DATE 2010 -09 -07 j
DESCRIPTION OF WORK
Remove and Replace roof, One section of gutter and small section of siding replaced as well
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor REScheck /COMcheck SUBMITTED: NA
DEPOSIT HELD: BUILDING PLANS SUBMITTED: NA
N/A
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I. 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
Bui ding Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a pl'�ation. �
gnat eofApplicant Date