CN-2011-00479_0001 (2).tif i
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
CN- 2011 -00479 a o »rse o www.blairnebraska.org
10/27/2011 COM -NEW Commercial March 1, 2012
LOCATIONOFIMPROVEMENT: 1364 Washington St, Blair, NE 68008
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ARCHITECT: GENERAL Kiewit Building Group Inc.
OWNER: Goodwill Industries, Inc CONTRACTOR: 3921 Mason St
s APE 4805 N 72nd St OMAHA, NE 68105
OMAHA, NE 68134
NATURE OF WORK PROPOSED USE
New Construction Primary Commercial
PROJECT NAME PERMIT EXPIRES 10/26/2013
1364VUashingtonSt- 111027 -New Commercial ESTIMATED COMPLETION DATE 2012 -05 -31
DESCRIPTION OF WORK
New commercial building - Goodwill Store
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: Received
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
di Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
r f pliC i n.
Date
Signature of Applicant