ms-2015-325_0001.tif CITY OF BLAIR
f 210 S.16TH STREET
BLAIR, NEBRASKA 68008
-4191 i LICi {402} 426 -4191 - Phone
��� y' (402) 426 -4195 - FAX
MS -2U I5 -UO325 a ' °n/ 01 a www.blairnabraska.org
04!29/2015 MISC Residential April 29, 2015
LOCATIONOFIMPROVEMENT: 15070 Cord 18, Blair, NE 60008
ARCHITECT:
GENERAL McKinnis Roofing & Sheet Metal
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OWNER: Juanita And Eleazar Cortez -Baeza Cortez CONTRACTOR:
164 S 1st St
1815070 Co Rd Blair, NE 68008
BLAIR, NE 68008.0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT (NAME PERMIT EXPIRES 04!28/2017
15070Cord 18- 150429.2014 Storm Damage
ESTIMATED COMPLETION D ATE 12131l2015
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DESCRIPTION OF WORK
Roof, siding, gutters, windows,
DEPOSIT LAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is issued.
8. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
apps` ation.
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Signature of Appl ant Dot$