MS-2014-01186.tif l
CITY OF BLAIR
218 S. 16TH STREET
,
BLAIR NEBMSKA68008
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(402) 470 -4191 - Phone
` agtai�,ls %1 �, IN ` Ui In Perm L App lication
. , (402) 426 -41 - FAx
MS-2 Ise of Af�fi www.blairnebraska.org
0711012014 MISC Residential July 10, 2014
LOCATION OF IMPROVEMENT: 2419 Elm Dr, Blair, NE 88008
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,i ARCHITECT: GENERAL McKinnis Roofing & Sheet Metal
X CONTRACTOR:
OWNER. Frank Jason And Jennifer J Fowler 164 S 1st St
art
Blair, NE 68008
2419 Elm Dr
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PERMIT EXPIRES 0710912016
PROJECT NAME
2419EImDr- 140710 -2 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORD
Roof and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT 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 f
application.
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signature of App icant bate