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CITYOF GLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Ut lin Permit Application (402) 426 -4191 - Phone
g pp
9
(402) 426 -4195 - FAX
MS 2014-01823 A'Or Oise of a� www.blairnebraska.org
07/31/2014 MISC Residential July 31,2014
LOCATION OF IMPROVEMENT: 2042 Nebraska St, Blair, NE 68008
ARCHITECT:
GENERAL McKinnis Roofing & Sheet Metal
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� OWNER: Darin And Dawn A Andersen CONTRACTOR:
b�E m
F; 164 S Ist St
- ' 2042 Nebraska St Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 07130/2016
2042NebraskaSt- 140731 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, 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.
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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
app ication.
! ` � A (
Signature of kpplicant Date
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CITY OF BLAIR
t` 218 S. 16TH STREET
( i BLAIR, NEBRASKA 68008
Bu ildin g P ermit Application (402) 426- 4191 - FAX
{402) 426 -4195 -FAX
MS- 2014 - 01796 p ` °s o4 �s� www .blAirnebraska .org
p
07131/014
7 7msc Residential July 31, 2014
LOCATION OF IMPROVEMENT: 1756 Lincoln St, Blair, NE 68008
ARCHITECT; GENERAL McKinnis Roofing & Sheet Metal
OWNER: Gaye M And Russell J Moseman Moseman CONTRACTOR:
164 S 1st St C
17'55 Lincoln St Blair, NE 65008
BLAIR, NE 6$008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
i
PROJECT NAME PERMIT EXPIRES 07130
1756LincoinSt- 140731 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
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 j
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.
Signature ofTApplicant Date
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