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CITYOFBLAIR
218 S. 16TH STREET
BL.AI, NEBRASKA6800
ap Application ( 2) 426.4191 - Phone
®
(402) 42 195 - FAX
° dis c av
WWW .bIaIrnehraaka.org
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09/19/2014 b MISC Commercial September 22, 2014
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�OCATIONOFIMPROVE ENT. 22 42 Wright St, Blair, NE 6800$
ARCHn"ECT-
GENERAL McKinnis Roofing & Sheet Metal
UWNER: Good Shepherd Lutheran Home CONTWTOR:
164 S 1st St
2242 Wright St Blair, NE 68008
B lair, NE 68008
. .
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PRO JECT NAME P ERMIT EXPIRES 09/18/2016
2242WrightSt 140919 - 2014 Storm Damage
E S TIMATED COMPLETION DATE 12131/2014
DE SCRIPTI ON
Re roofing, windows, siding, gutters for Good Shepherd.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
EScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITT 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.
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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
application.
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Signature 4� ppflcant Date