3233.tif CIrYOFBuAIm
21 S. 16TH STREET
BLAIR, NEBRASKA 68008
-4191 - Phone
Building Permit Application
WS-2014-03233 /Se 01 www.blairnebraska.org
11/0412014 intern MISC Residential November 6, 2014
LOCATIONOFIMPROVEMENT, 313 N 22nd St, Blair, NE 68008
GENERAL McKinnis Roofing & Sheet Metal
CONTRACTOR
OWNER: Benjamin Larsen
313 N 22nd St Blair, NE 68008
BLAIR, NE 68008-0000
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 11/04/2016
313N22ndSt-I 41104-2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, painting, siding, soffitm fascia, guttes, windows
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
1.NA work will be started before permit is ISSUED AND POSTED.
2. For commerc penn|ta, o set of plans for this must be oVbmKbad to the Nobnyoha State Fire [Nanyhe|'a Offima 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 penn|L |t|o further understood that construction covered by this permit application shall not becommenced until
copy ofo permit signed by the Building Inspector ioissued,
5. The undersigned owner or agent egnaeo to perform the proposed work in accordance with the specifications set forth above and
in accordance w ith h codes/ ordinances 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 0 | shall t| sufficient d for thenavocmdonofenyperm|t|uauedvvhiohvveeb000dohthampprova\ofth\a
/�— 5
Date