MS-2014-01153.tif {
-,� CITYOF BLAIR
-' 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Perm
plication
(402) 426 -4'101 - Phone
(402) 426 -4195 - FAX
MS- Zp14 - Q1153 �'� °�,j www.blairnebraska.org
s° °�
07111/2014 MSG Residential July 11, 2014
'h 4
LOCATION OF IMPROVEMENT: 138 N 21st St, Blair, NE 68003
, ARCHITECT; GENERAL McKinnis Roofing & Sheet Metal
CONTRACTOR:
OWNER: Kenneth P Thompson 164 S 'Ise St
sari �� Y' Blair, NE 68008
7516707 Us Hwy
BLAIR, NEE 680 -0000
LLLJ
NATURE OF WORK Primary Primary .Residence
Storm Repair
PERMIT EXPIRES 07/1012016
PROJECT NAME
138N21stSt- 140711 -201 Storm Damage ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DE 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 Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a lication.
bate
Signature of A licant