MS-2015-00651_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building unit Application (402) 426 -4191 - Phone
9 ��d (402) 426 -4195 - FAX
MS -2015 -00651 A 'Omrs e of a° www.blairnebraska.org
08/0712015 bpeterse MISC Commercial August 7, 2015
LOCATIONOFIMPROVEMENT: 767 Iowa St, Blair, NE 68008
ARCHITECT: GENERAL TIJ Construction
OWNER: Amy L And Rathbone, Amy Lynn Trustee Of CONTRACTOR:
Rathbone 1 -D Ave
3701 W 84th St Missouri Valley, IA 51555
x . PRAIRIE VILLAGE, KS 66206 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Commercial
PROJECT NAME PERMIT EXPIRES 0810612017
767lowaSt- 150807 -2014 Storm Damage
ESTIMATED COMPLETION DATE 1213112015
DESCRIPTION OF WORK
Remove and replace metal roof.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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x „ u� :,� r.. 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 j
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 and r�gd or any alteration or change from this application without approval of the
Building Official, sha nstitute sufficient ro n the revocation of any permit issued which was based on the approval of this
applica ' n.
i t of Applicant Date
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