MS-2015-00482.tif i
CITY OF BLAIR
218 S. 16TH STREET
BLAI NEBRASKA 68008
� i ' 1 1 11 I (402) 426 -4191 - Phone
(402) 426-4195 - F AX
NS -2015 -00482 ww
16/11/2015
MISC Commercial June 11, 2015
LOCATIONOFIMPROVEMENP 10602 Oak Park Ln, Blair, NE 68008
ARCHITECT.
GENERAL McKlnnis Roofing & Sheet Metal
` OWNER: Johan C And Nancy Pedersen CONTRACTOR
164 S 1st St
10602 Oak Park Ln Blair, NE 68008
BLA IR, NE 68008 -0000
NATURE OF WORK STRUCTURE
i
Storm Repair Primary Commercial
J T PERM I 06/10/2017
10602®akParkLn- 150611- 2014Storm ES TIMA TED L TI ON DA TE 12/31/2015
Damage
DESCR IP TION F WORK
Remove /Replace fully adhered 60mil TPO roofing system.
DEPOSIT PAID BY. SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50 i
e
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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ignature a,: pplicant Date