ms-2015-323_0001.tif i
CITYOF BLAIR
218 S.16TH STREET
BLAIR, NEBRASKA 68008
B uilding i llca ion (402) 426 -4199 - Phone
MS- �p (402) 426 -4995 - FAX
terse of www.blairnebraska.org
0412912015 MISC Residential April 29, 2015
LOCATIONOFIMPROVEMENI 860 N 11th St, Blair, NE 68008
i= ARCHITECT
GENERAL McKinnis Roofing & Sheet Metal
OWNER: don B Nutzman CONTRACTOR:
164 S 1st St
860 N 11th St Blair, NE 68008
BLAIR, NE 68008- 0000
K z t � 3; fl✓ : e g � r✓ ✓,
NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 04/2812017
860N11thSt- 150429 -2014 Storm Damage ESTIMATED COMPLETION DATE 1213112015
DESCRIPTION OF WORK
Roof on house and shed, gutters, siding garage door, windows and screens, storm door, painting.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheckiCOMcheck 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
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
ap 'cation.
Data
Signature of A iicant