ms-2015-00971.tif ii
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CITYOFBLAIR
218 S.16TH STREET
BLAIR,NEBRASKA68008
Application (402)426.4191 -Phone
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(402 426.4195-FAX
- - �a�° �r ®t av° .blairnebraska.org
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JShell"512ShellY J M15 Residential November2v,2015
LOCATIONOFIMPROVEMENT: 8961 Cord P35,Blair,NE 68008
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i ' � GENERAL McKinnis Roofing &Sheat Metal
OWNER: Andrew D And Shelly L Andreasen
CONTRACTOR:
' 164 S 1st St
Blair,NE 68008
a � BLAIR,NE 68008-0136
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NATURE OF WORK STRUCTURE
Storm Repair Primary
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PERMIT EXPIRES
s:
11/24/2017
PROJECT NAME
9961 Cord P35-151125-2014 Storm Damage
ESTIMATE® COMPLETION ®ATE 6130/2016
DESCRIPTION OF WORK
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Remove and replace metal roofing, eave trim, high eave metal & gabel trim.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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211
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777177,
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 codestordinances 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
ap lication.
11,25J15
Date
Signature Applicant
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