MS-2011-00083_0001.tif FromACKINNIS ROOFING & SHEET METAL 402 426 2344 04/05/2011 12:38 #144 P.003/003
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CITY OF BLAIR
218 S. 18TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 -4191 -Phone
A ` w (402) 426 -4195 - FAX
MS-2011-00083 rtl mlae of q�0 www .blairnebraska .org
p
Q3124/2011
b eterse MISC Residential March 24, 2011 i
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LOCATIONOFIMPROVEMERP 12376 Earl Ave, Blair, NE 68008 f
i ARCHITECT: GENERAL. McKinnis Roofing & Sheet Mehl
n OWNER: Brenton Communities CONTRACTOR: 164 S 1st St
8610 Thompson Dr Blair, NE 68008
Blair, NE 68008
NATURE OF WORK PROPOSED USE
RaofinglSoffit/EaveslGutters Primary Residence
PROJECT NAME PERMIT EXPIRES 03/23/2013 i
12376EariAve- 110324- Roofing ESTIMATED COMPLETION DATE 2011 -04 -30
DESCRIPTION OF 'WORK i
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Remove and Replace Roof
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor i
REScheck[COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMTTED: NA
$50
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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 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 O Ic f, all constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicatio .
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Date Signature of Applicant
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