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t r CITY OF SLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
UilCll1C,, E'1"t11It }pICi�[Oil {402) 426 -4191 - Phone
(402) 426 -4195 •PAX
VIS- 2014 ~031 05 p10 I 'se 01 www.blairnebraska.org
10121/2014 Fir tern MISC Residential October 22, 2014
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LOCATIONORMPROVEMENT: 267 N 21 st St, Blair, NE 68008
ARCHITECT:
GENERAL McKinnis Roofing & Sheet Metal
} CONTRACTOR
OWNER: Roger Ray Sutherland
> 164 S 1st St
267 N 21st St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 10121/2016
267N21 stSt- 141021 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112
DESCRIPTION OF WORK
Roof house shed and garage, windows, siding
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
RESchecklCOMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appli Lion
he
signature of App scant Date