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CITYOF GLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68408
�. � ►� 'y i i�'1 r (402) 426 -4191 - Phone
Buil Permit
-� (402) 426 - 4195 - FAx
MS -2014- 02015 / a i q� www.blairnebraska.org
11 W
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0$/0812014 , 11IlISC Residential August 8, 2014
LOCATIONOFIMPROVEMENT: 734 N 15th St, Blair, NE 68008
y ARCHITECT:
A GENERAL McKinnis Roofing & Sheet Metal
f OWNER: Leslie P And Wf Miller CONTRACTOR:
Yr i 164 S 1st St
734 N 15th St Blair, NE 68008
BLAIR, NE 68008 -0000
w ,
NATURE O F W STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/07/2016
734N15thSt- 140808 -2014 Storm Damage
ESTIMATED COM PLETI ON DATE 12/3112014
DESCRIPTION OF WORK
Roof, gutters, siding, windows
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 avocation of any permit issued which was based on the approval of this
appii ation,
r
Date
Signature of Appli nt