RE-2011-00176_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (4 02 ) 426-4191
-Phone
(402) 426 -4195 - FAX
RE- 2011 -00176 ''a, o�` www.blairnebraska.org
05/20/2011 REMODEL Commercial May 26, 2011
LOCATIONOFIMPROVEMENT. 810 N 22nd St, Blair, NE 68008
� ARCHITECT:
GENERAL Hawkins Construction Co.
a) OWNER: Memorial Community Hospital CONTRACTOR: 2516 Deer Park Blvd
PO Box 250 Omaha, NE 68105
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Remodel Primary Commercial
PROJECT NAME PERMIT EXPIRES 05/1912013
81 0N22ndSt-1 10520-1 ESTIMATED COMPLETION DATE 2011 -07 -31
DESCRIPTION OF WORK
Interior finish for a new Pharmacy Department. Includes fire sprinkler, mechanical and electrical work
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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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 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
applica 'on
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Signature ofAppli ant Date