MS-2014-01331_0001.tif i
07- 22 -'14 09;58 FROM -McCoy Roofing 4027155149 T -400 P0001/0001 F -334
a. 11 I vrou+
21 8 S. 16TH STREET
BLAIR, NEBRASKA68008
. Building Pe rmit A pplication (402) 42614191 - Phone
(402) 4264195 � FAX
MS- 2014.01331 r4mis at � °a� www.blalrnebraska.org
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07/1612014 intem MlSC Residential July 22, 24714
I.0CAn0N0FIMPR0VEMENr. 611 Hillcrest Dr, Blair, NE 68408
ARCHITECT GENERAL McCoy Roofing, Siding & Contracting
OWNER L oaann C Quist CONTRACTOR: 12909 Lakeview Or
SPRINGFIELD, NE 68059
611 Nllicrest
BLAIR NEBLAIR, NE 68008 -0000
NATURE O F WORK STRUC TURE
Storm Repair primary Residence
PROJECT NAME PERMIT EXPIRES 07/16/2016
611HiI1crestDr -2014 Storm Damage ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Roof, gutters, siding, windows
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck=Maheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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.
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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 codeslordinances 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
Official, shall institute sufficient ground for the revocation of any permit issued which was based on the approval of this
on.
S of Applicant Gat
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