ms-2015-335_0001.tif CITYOFBLAI
219 S.16TH STREET
BLAIR, NEBRASKA 68008
® (402) 426-4191 - Phone
u
Bu Pe rm i t I I (402) 426-4195 - FAX
MS - 2015 - 003 35 �'f� , g any www.blairnebraska.orp
0510112015
MISC Residential May 1, 2015
LOCATIONORMPROVEMENT: 1105 S Hwy 30, Blair, NE 68008
ARCHITECT: GENERAI. McKinnis Roofing & Sheet Metal
OWNER: Andrew D And Shelly L Andreasen CONTRACTOR:
164 S 1st St
9961 Co Rd P35 Blair, NE 68005
BLAIR, NE 69005 -0000
n.
NATURE OF WORK STRUCTURE
Storm Repair Andy's Mcwtown
NAME IT EXPIRES 04/30/2017
PROJEC
1185SFIwy 30- 150501 -2014 Storer Damage ES TIMATED L Ti ON DA TE 12)31/2015
DESCR IPTION F WORK
Remove and replace metal roof, wall panels, gutters /downspouts.
I
j DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck1COMcheckSUBMITTED: NA
I
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
E
$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
application.
Date
Signature f Applicant