MS-2014-01474_0001.tif CiTYOF BLAIR
218 S. 16TH STREET
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BLAIR, NEBRASKA 68008
Building Permit Application (} 426.4191 - Phone
MS -2014 -01474 'A` �lf@ os QJO``�s (402) azs -alas - FAX
www.blairnebraska.org
07/21/2014 bpeterse MISC Commercial July 21,2014
LOCAIIONOFIMPROVEMENT: 597 Grant St, Blair, NE 6800E
aRCHirr =Cr: GENERAL McKlnnis Roofing & Sheet Metal
OWNER: County Washington CONTRACTOR: 164 S let St
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Blair, NE 68008
1555 Colfax St
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE j
Washington County Extension Office
Storm Repair � ty
PROJECT NAME PERMIT EXPIRES 07/2012016
597GrantSt- 140721 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Re- roofing with asphalt, siding and windows for Washington County Extension Office.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA - County Building no charge
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: f
BUILDING PLANS SUBMITTED: NA
N/A
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
application.
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Signature of plicant Date