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—`� CITY OF GLAIR
218 S. 16TH STREET
j BLAIR, NEBRASKA 68008
Building Permit Application (402j 4264191 Phone
A (402) 426 -4185 -FAX j
MS- 2014.02282 `O rnIs p quq www.blairnebraska.org
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08119/2014 MISC Residential August 19, 2014
;! LOCATIONOFIMPROVEMENT: 403 W Baronage Dr, Blair, NE 68008
E "I ARCHITECT: GENERAL McKinnis Roofing& Sheet Metal
OWNER: James M Cook CONTRACTOR:
t 184 S 1st St
403 W Baronage Dr Blair, NE 68008
GLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE'
Storm Repair Primary Residence
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PROJECT NAME
PERMIT EXPIRES 08/1812018
403WBaronageDr- 140819 -2014 Storm
Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, gutters, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED:- NA
Contractor
REScheck/COM check 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
app ication.
Signature of Apj4lcant Date
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