2014.tif E
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CITYOFBLAIR
298 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426- 4191 - Phone
Building Permit it Application (402) 426- 4195 - FAX
www.blairnebraska.org
MS-2014-02014 miae al
k
08108/2014
MISC Residential August 8, 2014 E
LOCATIONOFIMPROVEMENT: 2868 Ravae Ln, Blair, NE 68008
qIR ARCHITECT: GENERAL_ McKnnis Roofing & Sheet Metal
E OWNER: David D And Lynne C Jackson Allen CONTRACTOR,
164 S '1st St
, 2868 Ravae Ln
Blair, NE 68008
BLAIR, NE 68008 -0000
}
NATURE OF WORK
STRUCTURE
Storm Repair .Primary Residence
PERMIT EXPIRES 08/07/2016
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PROJECT NAME
286BRavaeLn- 140808 -2014 Storm Damage ESTIMATED COMPLETION DATE 12
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 per 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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Date
Signature of A . licant
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