MS-2014-01908.tif CITYOFBLAIR
218S.16THSTREET j
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BLAIR, NEBRASKA 68008
ia�illir.hl ��iL I ,_< 1 Building Permit Application (4o2)4z6- 4181 -Phone
� (402) 426 -4196 - FAX
MS-2014-01908 4 `omr : of www.blairnebraska.org
0810412014 MISC
Residential August 4, 2014
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LocATIONOFIMPROVEMENT: 150 S 11th 8t Unit 13, Blair, NE 68008
+ ARCHfTECT:
GENERAL Nicttinnis Roofing &Sheet Metal ;
OWNER: Mary M CONTRACTOR
l�l 164 S 1st St
}`« 160 S 11th St Unit 13 Blair, NE 68008
Blair, NE 68008
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NATURE OF WORK STRUCTURE
Storm Repair Mobile Nome
PER EXPIRES 08/03/2016
PROJECT NAME
160S11thst- 140804 -2014 Storm Damage ESTIMA COMPLETION DATE 12/31/2014 !
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DESCRIPTION OF WORK
Roof and gutters j
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
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Contractor
REScheck1COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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1 a . 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. If 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
app! °ation:
Data
Signature of App ant
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