MS-2014-01484_0001.tif r " CITYOFBLAIR
J 218 S.'16TH STREET
1 1 BLAIR, NEBRASKA 68008
wilding Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS- 2014 -01484 a ` °Wi 01 Q ° www.blairnebraska.org
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07I2112014 MISC Residential July 21, 2014
LOCATiQNOFIMPROVEMENT: 844 S 17th St, Blair, NE 68008
�I. ARCHITECT:
GENERAL. McKinnis Roofing & Sheet Metal
OWNER: Janice J And Philip D Whitehead CONTRACTOR: 164 S 1st St
Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME
P ERMI T EXPIRES 07120/2016
844S17thSt- 140721 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31I2014
DESCRIPTION OF WORK
Roof, gutters
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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
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Building Officlal, shall constitute sufficlent ground for the revocation of any permit Issued which was based on the approval of this
apollbation.
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Signature of Ap licant' Date
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