MS-2012-00493_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 - 4191 -Phone
(402) 426 -4195 - FAX
MS- 2012 -00493 'OMi o` a o° www.blairnebraska.org
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10130/2012 MISC Commercial October 30, 2012
LOCATIONOFIMPROVEMENT: 1600 Washington St, Blair, NE 68008
ARCHITECT:
GENERAL Complete Exteriors
® OWNER: Denis J And Catherine E Hall CONTRACTOR: 7801 L St
11554 Cryer Ave OMAHA, NE 68127
OMAHA, NE 68144 -0000
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NATURE OF WORK PROPOSED USE
Roofing /SoffitlEaves /Gutters Primary Building
PROJECT NAME PERMIT EXPIRES 10/30/2014
1600WashingtonSt- 121030 - Roofing ESTIMATED COMPLETION DATE
11/112012
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DESCRIPTION OF WORK
Flat roof - reshingle - Tear off top layer
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: 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, s I cons itute sufficient ground for the revocation of any permit issued which was based on the approval of this
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Date
Signature o Applican
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