MS-2014-01511_0001.tif i
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CITY OF GLAIR
j� 218S.16TH STREET
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BLAIR, NEBRASKA 68008
„i f ^Il,li�ai i �t:� �►uIldi g Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS 2014 -01 511 10 is tit ago www,blairnebraska.org
07122/2014 MISC Residential July 22, 2014
LOCATIONOFIMPROVEMENT: 1046 N 20th Ave Circle, Blair, NE 68008
i ARCHITECT:
GENERAL McKinnis Roofing &Sheet Metal �
OWNER: Daniel F And Suzanne M Kirwan CONTRACTOR: 164 S 1st St
Blair, NE 68008
9394 W Dodge Rd
OMAHA, NE 68114 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/21/2016
1046N20th Ave Circle- 140722 -2014 Storm
Damage ESTIMATED COMPLETION DATE 12/31/2014
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DESCRIPTION OF WORK
Roof, gutters
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COM check SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 lication.
Signature of Ap' licant Date
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