ms-2015-00973.tif CITY OF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA68008
-
(402)426-4191. -Phone
Budding Permit Application
(402)426-4195-FAX
VIS-2015-00973
www.blairn.ebraska.org
11/2512015 Shelly) MISC Residential November25,2015
LOCAMNORMPROVEMENT 15070 Cord 18,Blair,NE 68008
ARCHITECT:
: GENERAL McKinnis Roofing & Sheet Metal
OWNER: Juanita And Eleazar Cortez-Baeza Cortez CONTRACTOR:
164 S 1st St
18 15070 Co Rd Blair,NE 68008
BLAIR,NE 68008-0000
NATURE OF WORK STRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 11/24/2017
15070Cord 18-151125-2014 Storm Damage
ESTIMATED COMPLETION DATE 6/30/2016
DESCRIPTION OF WORK
3 metal roofs and gutters
DEPOSIT PAID BY: SITE PIAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS:
BUILDING PLANS SUBMITTED; NA
$50
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. If 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 glair 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 fficial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applic to .
4�
!ignature of Applicant Date