2601.tif CITYOFBLAIR k
298 S. 18TH STREET
j BLAIR, NEBRASKA 68088
B uild in g (402) 426 -4191 - Phone �
r.,.., , r o�, ��P (402) 426 4995 - FAX t
MS- 2014 -02601 A'0 /se ai <'' www.blairnebraska.org
09104/2014 bpeterse MISC Residential September 5, 2014
x, LOCATION OF IMPROVEMENT: 921 N 25th Ave, Blair, NE 58008
ARCHITECT: GENERAL McKinnis Roofing &Sheet Metal
OWNER: Timothy Kaczor CONTRACTOR:
k 164 S 1st St
921 N 25th Ave Blair, NE 68008
BLAIR, NE 680080000
Mlii
}
NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 0910412016
921 N25thAve- 140904 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Reroof, gutters and siding,
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheek SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
xi
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 Office for review.
3. Separate permits are requlred 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 H 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 ion.
Signature of App ant Date
i