MS-2014-0274.tif t
1
i
I
--� CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
.n +l }ti��E. _� B uil d ing Pe Appl ic at ion
( 4 26-4191 - P
(402) 42ia -41 95 FAX
MS- 2014 - 0257 �` ° rsQ p � a ° °�� www.blairnebraska.org
IN
IN
09/0312914 ShellyJ MISC Residential September 3, 2014
COCATIONOFiMPROVEMENT: 822 N 25th Ave , Blair, NE 68008
ARCHITECT:
GENERAL McKinniis Roofing & Sheet Metal
OWNER: Patricia L And Richard S Co- Trustees CONTRACTOR
Sri Jorgensen 164 S '1st St
822 N 25th Ave Blair, NE 68008
BLAAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 09/02/2016
822N25thAve- 140903 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Reroof
DEPOSIT PAiD BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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 I
Building Official, shall constitute sufficient ground fur the revocation of any permit issued which was baaed un the approval of this
app cation.
Date
Signature of A licant
i
I
I