MS-2011-00474_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding C It Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
MS -2011 -00474 A'�m;se o � a o www.blairnebraska.org
10124/2011 bpeterse MISC Residential October 24, 2011
LOCATION OFLIMPROVEMENT: 13908 ord P33, lair, 68008
4 ARCHITECT: -
GENERAL SELF
OWNER: tal B ermeiste CONTRAC TOR:
r Blair, NE 68008
r LINCOLN, NE 68510 -0000
NATURE OF WORK PROPOSED USE
Roofing /Soffit/Eaves /Gutters Accessory Building
PROJECT NAME PERMIT EXPIRES 10/23/2013
13908CoRd P33- 111024 -Flood Repair
ESTIMATED C OMPLETI ON DATE 2011 -11 -30
DESCRIPTION OF WORK
Replacing roof with asphalt shingles on garage -flood damage.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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
application.
Date
Signature of Applicant