MS-2013-00362.tif Aug 28 13 01:58p Roof -Tech 1- 402 - 916 -4621 p.1
CITYOF BLAIR
218 S.16TH STREET
BLAIR, NEBRASKA 68008
Permit Applica (402) 426-4191 - Phone
�a (402) 426 -4195 - FAX
MS -201 3 -0 0 362 s `am, se �J www.blairnebraska.org
0812712013 bpeterse 7 M M 1SC MMMMMMM
Residential August 28, 2013
LOCATIONOFi MPROVEMENT: 457 N 23rd St, Blair, NE 68008
ARCHUECT:
GENERAL Roof -Tech Inc.
OWNER Rebecca L Smith CONTRACTS 8998 U St 230
457 N 23rd St OMAHA, NE 68127
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Roofing /SoMtlEaves /Gutters Primary Residence
PROJECT NAME PERMIT EXPIRES 08/2712015
457N23rdSt- 130827 -Roof ESTIMATED COMPLETION DATE 91112013
DESCRIPTION OF WORK
Re- roofing garage and section of house due to storm damage.
DEPOSIT PAID BY SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
NIA
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.
S. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codeslordinances of the City of Biair 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 i ation.
e
Date
5 lure of Applicant