MS-2014-0126.tif oITYouLAIR
u1VS.10THSTREET
BLAIR,NE8RAGKA 68008
Building Permit Application (402) 426-4191 - Phone
MS-2014-01261 Ise oi A' www.blairnebraska.org
Residential July 15, 2014
. 0711512014 MISC
u][AromoF|wpRovsmewr2219 Colfax St, Blair, NG68V0D
ARCHITEz
GsmsRm' Total Roofing Company
uvwvem Catherine L pitt «uwTnACTOn 10501 Chandler CirRm 100
L/Q/|STA 88128
SPRINGFIELD, NE 68059^0353
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PERMIT EXPIRES 07/1412016
NAME |
2218CuUaxSt44W715~2814 Storm Damage
ESTIMATED COK8PLGTUK]0 DATE 12/31/2014
DESCRIPTION OF WORN[
Roof, gutters, minor repairs
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchocWCOMchenkGU8K0|TTED: NA
DEPOSIT STATUS: ' BOlLD|NGPLANS SUBMITTED: NA
1.No work will be started before a permit io 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. |tie further understood that construction covered by this permit application shall not be commenced until o
copy ofa permit signed by the Building Inspector ioissued.
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 nftbo
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applicatiop. J
Date
Signature of Applicant