ms-2015-395_0001.tif I
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CITY OF BLAIR
21$ 5.16TH STREET i
BLAIR, NEBRASKA 6$008
i� in g Pe rmit (442) 428 - 4191 -1 ?none
(402) 428 -4195 - FAX
IBS -2015 -00395 °m 01 a�° www.blairnebraska.org
45/19/2015 M1SC Residential May 19, 2015
LOCATiONOFIMPROVEMENT: 1402 Grant St, Blair, NE 68008
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�Z ' ARCHITECT: GENERAL McKinnis Roofing & Sheet fetal
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r` OWNER: Donald And Susan Tolbert CONTRACTOR:
gal F`` 164S 1st St
1402 Grant St Blair, NE 68008
BLAIR, NE 68008.0000
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NATURE C}F �VORI STRUCTURE
Storm Repair Primary Residence
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PROJECT NAME PERMIT EXPIRES 05/1812017
1402GrantSt- 154519 -1 ESTIMATED COMPLETION DATE 12/31
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DESCRIPTION OF WORK
Roof and siding,
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
application. /
Signature of App cant Date