MS-2010-00154_0001.tif From:MCKINNIS ROOFING & SHEET METAL 402 426 2344 10111/2010 08:02 #753 P.002 /003
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
xi`it. .ib3 I 4i rr Bu i lding Permit Application (402)426 - 41$1- Phone
®154 b'on7l �°����' (402)426- 4195 -FAX
es eE a www.blairnebrasko.org
10/08/2010 M1SC ' Residential October 5, 2010
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LOCATIONOFIMPROVEMENr: 2059 Soren Or, Blair, NE 68008
a ? ARCHrtECr:
ORAL McKinnis Roofing & Sheet Metal
Bruce E And Cynthia K Kempcke j
- t4.. - OWNER: S�ONTI3ACTOR: 164 S 1st St
Y ' 2059 Soren Or Blair, NE 68008
BLAIR, NE 68008 -3655
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NATURE OF WORK PROPOSED USE
Roofing /Soffit/EavesiGatters Primary Residence
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PROJECT NAME PERMIT EXPIRES 1010712012
2059SorenDr- 101408 -Roof ESTIMATED COMPLETION DATE I
2010 -1p -31
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DESCRIPTION OF WORK
Roof, Gutters, Siding and Fascia on house. +
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck 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 i
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.
Signature of Applicant rs2t6
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