ms-2015-366_0001.tif I
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CITYOF SLAIR
21 ti S.16TH STREET
BLAIR, NEBRASKA 65009
�) Bu ilding Perm Appl ication (402) 426.4191 - Phone
L � gi a" (402) 426-4195 d FAX
a of www.blairnabraska.org
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0511212015 141(SC Commercial May 12, 2015
LOCATIONaFIiViPROVEMENT: 1620 Washington St, Blair, NE 66005
ARCH
GENERAL McKinnis Roofing & sheet Metal j
OMER: Frank E And Jolynn Wolff CO NTRACTOR:
164 S 1st St
` 654 Flilicrest Dr Blair, PEE 65005
BLAIR, NE 660050000
¥ 9
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NATURE OF WORK STRU CTURE
Sign Matt Wolff Jeweler
PRO JEC T NAME PERM EXP IRES 05/1112017
1620Washin tonSt- 150512- 2014Storm
D amage ES COMPLE T 12131/2015
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DESCR
Remove /Replace Mod Bit Roof, removeireplace shingles, remove /replace downspouts.
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DEPOSIT PAID BY: SITE FLAN SUBMITTED: NA
Contractor I
REScheck/COMch k 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
application.
Signatu of p
re !cant Date