MS-2015-00459.tif A CITY OF BLAIR
218 S.16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) ate -x191- Phone
(402) 426 -4195 - FAX
IS -2016 -00459 ,Se o, •`
www.blairnebraska.org
i /05/2015 Shelly) MISC Residential June 5, 2015
LOCATIONOFIMPROVEMENT: 829 N 24th St, Blair, NE 68008
ARCHITECT:
GENERAL. C & S Roofing Inc.
OWNER: Justin Flynn CONTRACTOR:
2211 Peoples Rd Ste B
829 N 24th St BELLEVUE, NE 68123
BLAIR, NE 68008 -0000
NATURE OF WORK STRUCTURE
Storm Repair Primary
)ROJECT NAME PERMIT EXPIRES 06/04/2017
829N24thSt- 150605 -2014 Storm Damage ESTIMATED COMPLETION DATE 1213112015
)ESCRIPTION OF WORK
Reroof and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
)EPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
No work will be started before a permit is ISSUED AND POSTED.
:. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
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.
.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, s II constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Inature of Applicant Date