MS-2014-01537.tif r
I
CITYOF BLAIR I
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 Phone
Building Permit Application
(402) 426 -4195 m FAX
MS 2014 -01537 A ` ° 'Is e of a� www. rnebraska.org
MI
07122/2014 intern SC Residential July 25, 2014
LOCATIONOFIMPROVEMENT: 1966 Colfax St Blair, NE 68008
,aRCHrrfcT: GENERAL McKinnis Roofing & Sheet Metal
r:t+ OWNER: Gregory L And Laura A Bloomfield CONTRACTOR:
164 S 1st St
1966 Colfax St Blair, NE 68008
4; BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07/2412016
1966ColfaxSt- 140722 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Roof, windows, siding, doors, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOM check 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.
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
ap lication. '
Date
Signature of Apficant
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