MS-2011-00393_0001.tif i
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CITY OF BLAIR
218 S. 16TH STREE T
BLAIR, NEBRASKA 68008
Building Permit Application
(402) 426 -4195 - FAX
MS- 2011 -0039
0911512011 MISC Residential September 15, 2011
LOCATIONOFIMPROVEMENT: 2259 Davis Dr, Blair, NE 68008
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ARCHITECT: GENERAL McKinnis Roofing & Sheet Metal
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OWNER: Christopher T And Angela K Ulven CONTRACTOR: 164 S 1st St
2259 Davis Dr Blair, NE 68008
BLAI'R, NE 68008 -0000 1
NATURE OF WORK PROPOSED USE
Roofing /Soffit/Eaves]Gutters Primary Residence
PROJECT
, E T PERMIT' EXPIRES 09/14/2013
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2259Davis Dr -tl 10915- hoofing
ESTIMATED COMPLETION DATE 2011 -09-30
DESCRIPTION OF WORK
Roofing, Siding, and Cutters.
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DEPOSIT PAID BY SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: NA
DEPOSIT STATUS. BUILDING PLANS SUBMITTED, NA
$ 50
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 frorn this .application without approval of the
Building Official, shpiLconstttute sufficient ground for the revocation of any permit issued which was based on the .approval of this
p l' ation.'
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Date
Signature of Applicant