MS-2015-00200_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
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B uilding Permit Application (402) 426 -4191 - Phone
pro -� � (402) 426 -4195 - FAX
MS-2015-00200
`h /se of q www.blairnebraska.org
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0313012015 bpeterse MISC Residential March 30, 2015
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LOCATIONOFIMPROVEMENT: 1555 N 28th Ave, Blair, NE 68008
ARCHITECT:
GENERAL K - Construction
OWNER: Paul F Kempcke CONTRACTOR:
E 1180 Voss Cir
1555 N 28th Ave Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Out Buildings
PROJECT NAME PERMIT EXPIRES 03/29/2017
1555N28thAve- 150330 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2015
DESCRIPTION OF WORK
Replacing Metal siding and metal roofing on two outbuildings.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
MIMI-
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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.
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Signature of Applicant