MS-2010-00224_0001.tif FromACKINNIS ROOFING & SHEET METAL 402 426 2344 11/11/2010 16;32 #861 P.0011001
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
° 8? • ° ` B uilding Permit Application (402)426 -4191 -Phone
MS-201 `, (402) 426 - 4 FAX
`OmrsB o+ 4 ° ° � www.blairnebraska,org
1110912010 MM I MMM tial November 9, 2010
LOCAMONOFIMPROVEMENT: 2733 W Hwy 91, Blair, NE 68008
ARCHrrECT: f
GENERAL McKinnis Roofing & Sheet Metal
OWNER: Jeffrey R And Michaela L Hume CONTRACTOR: 164 S "Est 5t
91 2733 W State Hwy Blair, NE 68008
BLAIR, NE 68008.0461 I
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NATURE OF WORK PROPOSED USE
RoofinglSofflt/Eaves /Gutters Primary Residence r
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PROJECT NAME PERMIT EXPIRES 11/4812012
2733WHwy 91- 101109 - Roofing
ESTIMATED COMPLETION DATE 2010.11 -30
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DESCRIPTION OF WORK
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Roof and Gutters Remove and Replace.
DEPOSIT PAID BY: SITE PLAN SUBMITTED; NA
Contractor
REScheck/COMcheckSUBMITTED: 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
Build[ Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app cat
Signature licant Date
9 pP