MS-2015-00038_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA68008
1l Permit Applica (402) 426 -4191 - Phone
WS- 2015 -0003 � ua�` (402) 426 -4195 - FAX
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www.blairnebraska.org
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H12712015 bpeterse 7MISC
Janua�27, 07 5
Gommercial
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LOCATIONORMPROVEMENT; 1698 Washington St, Blair, NE 68008
� ARCFIITECT;
GENERAL. McKinnis Roofing & Sheet Metal
j OWNER Koons, William A
CONTRACTOR
164 51st St
3410297 Co Rd Blair, NE 68008
- BLAIR, NE 68008.0000
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NATURE OF WORK STRUCTURE
Storm Repair Blair Maple Cafe
PROJECT NAME PERMIT EXPIRES 01/26/2017
shington5t- 150127.20146torm
Damag e ESTIMATED COMPLETION DATE 4/27/2015
Damage
DESC O F WORK
Remove and replace metal roof gutters and siding, 1 window and 1 door for Blair Maple
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck 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.
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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.
P
;Ignature of A leant Date
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