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CITYOF BLAIR
218 S. 16TH STREET
' BLAIR, NEBRASKA 68008
�U1ld111g Permit Application (402) 426 -4191 - Phone
q (402) 426 -4195 - FAX
MS- 2014 -02246 ° rise °l www. blairnebraska .org
0811812014 MISC Residential August 18, 2014
LOCATIONOFIMPROVEMENT: 716 N'16th St, Blair, NE 68008
r i ARCHITECT: GENERAL MCKlnnis Roofing & Sheet Metal
OWNER: Grace Baker CONTRACTOR:
164S1stSi
716 N 16th St Blair, NE 68008
BLAIR, NE 68008.0000
EV
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 0811712016
716N16thSt- 140818 -2014 Storm Damage ESTIMATED COMPLETION DATE 12131/2014
DESCRIPTION OF WORK
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Roof, siding, garage, window wraps
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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 codeslordinances 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
appli tion,
7-191-1 y
Signature of Appl' ;ant Date