SIGNED PERMIT APPLICATION (3).TIF i
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191- Phone (402)426- 4195 -FAX
MS- 2012 -00552 A ` " ", o� a ° °���,+ www.blairnebraska.org
12/04/2012 kathyl
MISC Residential December 4, 2012
LOCATIONOFIMPROVEMENT: 1419 Grant St, Blair, NE 68008
, ARCHITECT: GENERAL All American Pro
CONTRACTOR: 17814 County Rd. 25
' ® OWNER: James B And Blythe I Filipi HERMAN, NE 68029
1419 Grant St
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Primary Structure
Roofing /Soffit/Eaves /G utters
PERMIT EXPIRES 12104/2014
PROJECT NAME
1419GrantSt- 121204- Roofing ESTIMATED COMPLETION DATE 1215/2012
DESCRIPTION OF WORK
Repair the flat rubber roof on rear about a 5 ft sq area repair a 2 ft sq of asphalft shingles on front
DEPOSIT PAID BY:
SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMlTTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
Held
s' r��ra�r r� � �wi��'®'■ I
e
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
shall not not
be commenced a
t building permit. It is further understood that construction covered by this permit app'
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
f accordance with the codes /ordinf the undersigned ny alteration of Nebraska.
change from his application fwithout misrepresentation
pp oval t of the
fact with or without th tention of 9
Building Officia
applicat all constit ` en gro- und�fir the revocation of any permit issued which was based on the approval of this
io �
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gn of Applicant