2943.tif I
CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
rt - 402 425 -4191 Phone
B
uilding Permit Application t
(402) 426 -4195 - FAX
VIS 2014 - 02943 p' �`ntae o f a� www.blairnebraska.org
10102/2014 intern MISC Residential October 2, 2014
LOCATIONOFIMPROVEMENT: 1049 N 20th Avec, Blair, NE 68008
ARCH GENERAL McKinnis Roofing & Sheet Metal
�K OWNER: Glenn R And Amy L Coates coNTRacroR
164 S 1st St
1049 N 20th Ave Cir Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF W ORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 10/01/2016
1049N20thAvec- 141002 -2014 Storm Damage ESTIMATED CO MPLETION DATE 12/31/2
DESCRIPTION OF WORK
Roof, gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck 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 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 j
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.
Date
;ignature of A licant