MS-2013-00202_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application
(402) 426 -4191 -Phone
(402) 426 -4195 - FAX
MS- 2013 -00202 he 01 o� www.blairnebraska.org
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06/17/2013 brwheele MISC Residential June 17, 2013
LOCATIONOFIMPROVEMENT: 671 N 12th St, Blair, NE 68008
. ARCHITECT:
r GENERAL SWI Windows Doors &More
:
ti�j OWNER: Blair Housing Authority CONTRACTOR: 203E 7th St
758 S 16th St LOGAN, IA 51546
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Roofing /Soffit/Eaves /Gutters Primary Residence
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PROJECT NAME PERMIT EXPIRES 06/17/2015
671 N1 2thSt-130617-1 -Roofing ESTIMATED COMPLETION DATE 613012013
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DESCRIPTION OF WORK
One layer tear off and replacing with asphalt.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck /COMcheckSUBMITTED: NA
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DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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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
ap atioA
'D
% f gnature of Applicant Date
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Of I)LAIQ
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ROOF PERMIT SUPPORTING DOCUMENTS
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This supporting document includes information dealing with particular code
requirements and /or roofing permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2009 International Building
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your roofing permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the owner /contractor for this project.
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O r7 ccupaf►f� "� f � µ Contractor
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City of Blair Date
oP o.r�s�r
218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cltyofblair @cl.blair.ne.us Ea
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CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Perm A pp lication (402) 426 -4191 - Phone
, (402) 426 -4195 - FAX
MS -2013 -00203 a'�mise of 0o O ° www.blairnebraska.org
I
i
06/17/2013 brwheele MISC Residential Te 17, 2013
I
r LOCATIONOFIMPROVEMENT: 659 N 12th St, Blair, NE 68008
ARCHITECT:
GENERAL SWI Windows Doors & More
.� OWNER: Blair Housing Authority CONTRACTOR: 203E 7th St
aa,
758 S 16th St LOGAN, IA 51546
BLAIR, NE 68008 -0000
v ,
NATURE OF WORK PROPOSED USE
Roofing /Soffit/Eaves /Gutters Primary Residence
PROJECT NAME PERMIT EXPIRES 06117/2015
659N12thSt- 130617 -Roof 6/30/2013
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Tearing off and replacing with one layer of asphalt shingles.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
I
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
app ' n.
y turd'of Applicant Date
i
i