ms-2015-327_0001.tif IC I
CITYOFBLAIR
218 STREET
BLAIR, NEBRASKA 68008
r1i x ._r, Building Permit Application
{402) 426 -4191 -phone
{402) 426 -4195 - FAX
IVIS - I5 - 00327 gyp °n„ of ail ° ` ` www.blairnebraska.org
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04/2912015 MISC Residential April 29, 2015
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LOCATIONOFIMPROJEMENT: 2149 Lincoln St, Blair, NE 68008
I ARCHITECT: GENERAL McKinn "is Roofing & Sheet Metal
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OWNER: Taral E And Elizabeth Gift CONTRACTOR:
164 S 1st St
2149 Lincoln St 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
2149LincolnSt- 150429 -2094 Storm Damage 12/3'112015
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Siding only.
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 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' anon.
Signature of Appli ant Date
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