MS-2013-00448.tif , ~ CIT'YOF BLAIR
f 218 S, 16TH STREET
BLAIR, NEBRASItA 68008
J Building Permit Application (402) 4264191 - Phone
X402) 426 -4195 - FAX
M S-2013-00448 � ci �;��� wwww.blairnebraska.org
10103/2013 bpeterse 11SC Residential October 3, 2013
LOCATOONOFIMPPROVEME.NT: 523 N 12th St, Blair, NE 68008
ARCHlT:ECT: GENERAL McKinnis Roofing & Sheet Metal
OWNER: Ronald L And Sharlene Moore COaTRX - 3TOR. 164 S 1st St
523 N 12th St Blair, NE 68008
BLAiR, NE 68008 -0000
i
NATURE OF W ORK PROPOSED USE
Roofing /Soffit/EaveslGutters Primary Residence
PROJECT NAME PERMIT EXPIRES 1010312015
623Nl 2thSt -9 3'1003- Roofing ESTIMATED COMPLETION DATE '1011512013
DESCRIPTION OF WORK
Re -roof on house and garage with asphalt shingles.
i
DEPOSIT PAiD BY SITE PLAN SUBMITTED: NA
Contractor
REScheck]CO check SUBMITTED: NA
iDElr'UBiT STATUS: BUILDING PLANS SUBMITTED; NA
50
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 Eire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, beating, 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 with t the intention of the undersigned or any alteration or change from this application without approval of the
Building Official, h 11 constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
� r l atio _
w
Signature of Applicant;. Data
j