MS-2011-00169_0001.tif i
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
� � Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
MS 2011 - 00169 "I of 0o www.blairnebraska.org
05/1712011 bpeterse MISC Commercial Ma7,
LOCATIONOFIMPROVEMENT: 1616 Butler St, Blair, NE 68008
ARCHITECT:
GENERAL Riverside Construction, Inc.
OWNER: Blair City Schools CONTRACTOR: 315 S. 20th St
140 S 16th Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Roofing /Soffit/Eaves /Gutters School
PROJECT NAME PERMIT EXPIRES 05/16/2013
1616ButlerSt- 110517 - Roofing ESTIMATED COMPLETION DATE 2011 -06 -25
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DESCRIPTION OF WORK
Tear off existing roof and installing iso insulation, installing wood fiber insulation, installing 3 layers of fiber glass
felt and hot asphalt, install one layer of modified bitumen in hot asphalt, install pea gravel in hot asphalt.
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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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicatio ,:f
Date
Signature of Applicant
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