727.tif I
CITYOFBLAIR
218 S. 16TH STREET
7 BLAIR, NEBRASKA 68008
'F.K's.lp ii= r u i ding Permit pplication ( 402 ) 426 -4191 - Phone
_ �\ (402 426 -4195 •FAX j
MS - 2014.00727 14 ISO of ��° www.blairnebraska.org
06/3012014 MISC Residential June 30, 2014
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, L.00ATIONOFIMPROVEMENT 1145 Maple Dr, Blair, NE 68008
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ARCHITECT: GENERAL McKirinis Roofing & Sheet Metal
OWNER; Robert Patrick And Wendy Kay Rand CONTRACTOR: 164 S 1st St
Blair, NE 68008
1145 Maple Dr
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/29/20
1145MapieDr- 140630 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Roofing and shed roofing
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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
Building Official shall constitute sufficient rou
fact with or without the intention of the unde rsigned or any alteration or change from this application without approval of the
g ground for the revocation of any permit issued which was based on the approval of this
ap licatiorl. , I
Signature of Ap licant Date