MS-2010-00168_0001.tif i
From:MCKINNIS ROOFING &SHEET METAL 402 426 2344 1011912010 08:00 #777 P.002/005
CITY OF BLAIR
218 S. 1 6TH STREET
BLAIR, NEBRASKA 68008
fr °trF Building Permit Application (402)4264 -Phone
�t (402) 426 -4195 - FAX
MS -2010 -0016$ A ' °mg o, a� °�` www.blairnebraska.org
10115/2010 MISC Residential October 16, 2010 j
LOCATIONOFIMPROVEMENT: 970 N 14th St, Blair, NE 68008
ARCHITECT: i GENERAL McKinnis Roofing &Sheet Metal
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' OWNER: Terence C And Kathryn A Doll CONTRACTOR: 164 S 1st St
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970 N 14th St
�. Blair, NE 68008
BLAIR NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Roofing /Sa#fit/Eaves /Gutters Primary Residence
PERMIT EXPIRES 10/14/2012 I
PROJECT NAME j
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97 101015 - Roofing ESTIMATED COMPLETION DATE 2010 -10-31
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DESCRIPTION OF WORK
Remove and Replace roof, asphalt shingles. Section of gutters being replaced also.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck1COMcheckSUBMITTED NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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
P n ature Hcation of Applicant Date
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