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CITY0F BLAIR
218 S. 16TH STREET j
Bui lding Perm Applicat BLAIR,NEBRAS 68008
(402) 426 -4191 - Phone
�,►� ( 2) 426.4195 - F
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0 a1 .blairnebraska.org
09119/2014 bpeterse MISC Commercial September22, 2014
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LOCATIONOFIMPROVEMENT: 805 N. 22nd St, Blair, NE 68008
ARC HITE CT : GENERAL- McKinnis Roofing & Sheet Metal
i- Johansen M anor CONTRACTOR:
164 S 1st St
805 N. 22nd St Blair, NE 68008
Blair, NE 68008
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PRO J E CT NAME PERM EXPIRES 09118/2016
805N. 22ndSt- 140919 -2014 Sturm Damage
EST IMATED COMPLETION D 12/3112014
D ESCRIPTI ON
R e-roofing, siding, gutters and windows.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMcheck SUBMITTED: 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 g g g g 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.
Signatu a of Applicant Date