MS-2015-00758.tif CITYOFBLAIR
/ 218 S.16TH STREET
BLAIR, NEBRASKA 68008
402 426.4191 - Phone
' (402) 426 -4195 - FAX
MS - 2015 - Ise °s �u www.blairnebraska.orcg
08/31/2015 MISC Residential August 31,2015
LOCATION OFIMPROVEMENT. 452 N 21st St, Blair, NE 68008
k ARCHITECT. GENERAL I�icKinnis Roofing & Sheet Metal
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s # OWNER: Jeff Combs CONTRACTOR:
164 S 1st St
.`: 452 N 21st St Blair, NE 68008
s BLAIR, NE 68008.0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 08/30/2017
452N21stSt- 150831 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2015
DESCRIPTION OF WORK
Siding.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/ieck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED- NA
$50
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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 cod es /ordinanoes 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 j
ap a ion.
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Signature of Appli n# Date