MS-2010-00152_0001.tif From:MCKINNIS ROOFING & SHEET METAL 402 426 2344 10/11/2010 0$:02 #753 P.001 /003
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CITY OF BLAIR
218 S. 16TH STREET
i BLAIR, NEBRASKA 68008
R f ._:. Building Permit Application (402)426-4194 -Phone
a, (402) 4264196 - FAX
MS -2090 -001 22 _ou °i a °° www.blaimebraska.org
90/0812090 MtSC Residential October 8, 2010
• > >. LOCATMOFIMPROVEMENT 1450 Adams St, Blair, NE 68008
a A.RCI9ECT
ro . GENERAL McKinnis Roofing & Sheet Metal
OANER: Marc Lee Modelski CONTRACTOR: 164 5 9st St
9450 Adams St Blair, NE 68008
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BLAIR, NE 68008.0000 I
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NATURE OF WORK PROPOSED USE j
Roofing /Soflit(EavesiGutters Primary Residence
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PROJECT NAME PERMIT EXPIRES 1010712092
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1450AdamsSt 101008 -Roof
I ESTIMATED COMPLETION DATE 2010 4 0 - 39 I
DESCRIPTION OF WORK
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Roof and Gutters on both house and garage, C
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck1COMcheck SUBMITTED: 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. I
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.
6. 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
applicat
Date
Signature of Appiican
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