3287.tif CITYOFBLAIR
CC -) 218 S. 16TH STREET j
BLAIR, NEBRASKA 68008
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Buil Permit Application (402) 426.4`191 - Phone
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VIS- 2014 -03287 � �a``� (402) 426 -4195 - FAX
'�'� 0 0� www.blairnebraska.org
11/13/2014 bpeterse MISC Residential November 13, 2014
, LOCATIONOFIMPROVEMENT: 1038 N 24th Ave, Blair, NE 53008
ARCHITECT: GENERAL
McKinnis Roofing Sheet Metal
OWNER: Joshua A And Jacqueline K Konwinski CONTRACTOR:
184 S 1st St
1038 N 24th Ave Blair, NE 68088
BLAIR, NE 08008 -0000
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.., .. . t. ,.. , :,; _ ..:. ,.,, ...,„ ,F. ' s ^. � � ,✓ :mow" � =`- ,,.e,'.^`a . 3. � Y NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAIVE PERMIT EXPIRES 11/12/2016
1038N24thAve-141113 -2014 Storm Damage
ESTIMATED COM PLETION DATE 12/31/2014
DESCRIPTION OF WORK
Roof, gutters, siding, garage door, windows, front storm door,
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck 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 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
app 'cation.
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fignature of A nt Date
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