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MS-2013-00407.tif CITYOF BLAIR 218 S. 16TH STREET BLAIR, NEBRASKA 68008 11 I M; Building Perm App licat i on (402) 426-4191 -Phone (402) 426 -4195 - FAX MS- 2013 -00407 A10 ise o , a "� www.blairnebraska.org 09113/2013 bpeterse MISC Residential September 13, 2013 LOCATIONOFIMPROVEMENT: 1310 Wilbur St, Blair, NE 68008 Lr, ARCHITECT: GENERAL Denny's Roofing °, y i) OWNER: Charles R And Shirley M Bolton - Grandg CONTRACTOR: 2400 Hollow Rd tGt Blair, NE 68008 BLAIR, NE 68008 -0000 NATURE OF WORK PROPOSED USE Roofing /Soffit/Eaves /Gutters Primary Residence PROJECT DAME PERMIT EXPIRES 09/13/2015 1310WilburSt- 130913 -Roof 9/30/2013 ESTIMATED COMPLETION DATE DESCRIPTION OF WORK Tearing off roof on garage only and replacing with asphalt. DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA NA REScheck /C0Mcheck SUBMITTED: NA DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA N/A ` !Au 4 ' +� tub , ; 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 f r r �pplication. Date' Si ature of Applicant f r LAI" CITY 0 ROOF PERMIT SUPPORTING DOCUMENT 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. � Owner /Occupant �` ontractor w City of Blair 218 South 16th Street • Blair, Nebraska 68008 • 402 -426 -4191 • Fax 402 -426 -4195 • E -mail cifyofblair @cl.blair.ne.us