MS-2015-00010.tif m CITYOF BLAIR I
v ` 218 S. 16TH STREET C
BLAIR, NEBRASKA 68008
� �- Building Permit Application (402)426 -4191 - Phone
(402) 426 -4195 - FAX
MS - 2015 -00010 Ise of www.blairnebraska.org
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01/09/2015 ShellyJ MISC Commercial January 9, 2015 j
LOCATIONOFIMPROVEMENT: 1130 S Hwy 30, Blair, NE 68008
ARCHITECT:
GENERAL Bennett Construction
� OWNER: Gary J And Christine R Mcdonald CONTRACTOR:
P O Box 233 St
995 East Shore Dr Kennard, NE 68034
LAKEVIEW, IA 51450 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 01/0812017
1130SHwy 30- 150109 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Replacing metal roof
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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
fact with or.:w ho 1the intention of the undersigned or any alteration or change from this application without approval of the
Building Official hall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appli ,-a
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Date
Siature of Ap ant
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