KODIAK TWNST BK 1 LT 25 - ZCP 1/2/2026BUILDlNG PERM !T NUMBER DATE ISSUED
VALUAT ION : (BASIS)BLDG PERMIT FEE
AMOU NT PLAN CHK FEE
TOTAL
SANITATION PLAN APPROVAL BY AN AOEC.CERTIFIEO INSTALLER IS
REQU!REO PRIOR TO ISSUANCE OF A BU!LDING PERMIT WHERE PUBLIC
wATER ANO/OR SEwER tS NOT AVAILABLE FROM A CERTIFICATEO
MUNICIPAL SYSTEM.
PLOT PLAN
(A S|TE PLAN MAY ALSO BE REGIUIRED)
REAR PROPERTY LINE.l-.J--.-t-
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INSTALLER'S PLAN APPROVAL RECEIVED
FRONT PROPERTY LINE
ST R EET
NOTE: APPLICANT SHALL SHOW BUILDING SETBACKS
FROM PROPERTY LINES. A5 PERPENDICULAR OISTANCES
FROM PROPERTY LINES TO BUILOING. OIMENSIONS OF
STRUCTURE SHALL BE SHOWN ON THE PLAN.
ZONING CODE COMPLIANCE
INSTALLER
THE ISSUANCE OF A PERMIT. EITHER E OWNER OF THE
PROPERTY OR HIS AUTHORIZED AGENT MUST SIGN THIS APPLICATION OFI
GRANT OTHER WRITTEN PERMISSION FOR THE OESCRIBEO WORK TO BE
PE R FO RM ED.
TAX LOT NO. OATE
owNER PeR
(FOR OFFICE USE ONLY: C IRCLE)
I. OCCUPANCY GROUP
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2. TYPE OF CONSTRUCTION
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FR N H.T
ZON ING DISTR ICT
TYPE.OF OCCUPANCY
NO. OF STORIES TOTAL HGT
IOWNERSHIP TRANSFERREO, IN PROCESS, TO
CLOSING OATE, OEEO RECOROEO
APPROVED, BUILDING OFFICIAL
PE R.
(BY)
AREA OF LOT
SETBAC KS F ROM P ROPEhTY LINES:
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REGI'D OFF.STR EFT PAI KING=C.U.P. OR VARIANCE
I HEREBY ACKNOWLEDGE THAT I HAVEREAD THIS APPLICATION, THAT IT IS
CORRECT, AND THAT I AGREE TO COMPLYWITH ALL ORDINANCES AND LAWSREGULATING BUILDING CONSTRUCTION.
APPLICANT
APPROVED, ZONI NG OFFICER
,
suBDrvlsloN/suRVEY CLASS AND SCOPE OF WORK
LOT NO.BLOCK NO
STREET ADDRESS
NEAREST CROSS STREET
INSPECTION SCHEDULENO. OF BUILDINGS NOW ON LOT
DEMOL I SH
PR IVATE
OV
NIrLALTE R AT IO
ADDIT ION
NEW
USE OF BUILDING
IZE OF BUILDING
IREPATR
HGT
FLOO R Sr.rO. OF ROOMa
NIO. OF FAM ILIES
USE OF BUILDINGS
E'zE oF uor
WATER: PUBLIC
PR IVATESEWE R : PUBLIC
SPECIFICATIONS
EACH OF THE ABOVE INSPECTIONS MUST BE REGIUESTEO ANO THAT
WORK APPROVEO PRIOR TO ANY ADOITIONAL WORK PROGRESSING
BEYOND THAT POINT. AS REQUIREO 8Y U8C SECTION 305. FOR EACH
TION. 24 HOURS NOTICE IS REQUIREO. TELEPHONE THE KODIAK
ELECT R ICALPLUMBING
FRAME
FINAL FINISH
INSPEC INEERING OEPART
ROUG H
FINISH
FIXTU RES
FOUNDATION ROUG H
GAS
SEPT IC TA N K
SEWE RPLASTER/BD
FLUES
G
BU ILDING
MOTO RS
FINAL
NOTES:
AT EACH ORIVEWAY ACCESS TO THE PROPERTY
NAME
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MAILING AODRESS
CITY, STATE
I NAME
ADDRESS
C ITY. STATE
NAM E
ADDR
C ITY, STATE
LlsrATE LICENSE NO
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TELEPHONE
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ST
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WALLS
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WATER HTR
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INSULATION. FNDN
FURNACE, TYPE
BU ILDING DEPARTMENT KODIAK ISLAND BOROUGH
(AppLtcANT TO F|LL tN ALL TNFORMATTON WITHIN HEAVY LINES.
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
PLEASE PRINT, USE BALL.POINT PEN, AND PRESS FIRMLY.)
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F
CLASS OF WORK
DE MOL ISH
BUILDING ADDRESS
ALTE RATION REPA I R
DATE ISSUE DBUILDING PERMIT NO
LOC AL IT Y
MOVEADDIT ION BLDG. FEE SNEAREST CROSS ST
USE OF BUILDING
SIZE, OF BUILDING HE IGHTNAME PLAN CHK. FEE
NO. OF ROOMSMAIL ADDRESS
NO. OF FLOORS TOTA L
VALUATION
NO. OF BUILDINGS BUILDING PLUMBING ELECTRIC
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Bo C ITY TEL, NO
NO. OF BUILDINGS NOW ON LOT FOUNDAT I ON ROUGH ROUGHNAME
NO. OF FAMILIES F RAME SEPTIC TANK F IN ISH
SIZE OF LOT PLASTER SEWE R F IXTU RE5ADDRESS
USE OF BLDG. NOW ON LOT FLUES GAS MOTORSC ITY
SPECIFICATIONS F INAL F IIJISH FINAL
FOUNDATION
btrLrJ lrJ
FUJ
cIt;STATE LICENSE NO
EXTE R IOR .PIERSMATE R 1A L
NAME
WIDTH OT TOP
WI DTH OF tsOTTOMADDRESS
DEPTH IN GROUND
CI TY R.W. PLATL (StLL)
SI ZE SPA.SPAN
GoFU
trFzoo STATE LICENSE NO.
GIRDERS
JOIST lst. FL.
JOIST 2nd. FL
SUBDIVISION
JOIST CEILING
EXTE RIOR STUDS
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LOT NO BLK
INTERIOR STUDS
ROOF RAFTERS
BEARING WALLS
COV ERING
EXTERIOR WALLS ROOF
REROOFINGINTE RIOR WALLS
FLUES
F I REPLACE FL. FURNACE
WATER HEATER
F URNACE orLGAS
DO NOT WRITE BELOW THIS LINE
2- Occupancy Group A, B, C, D, E,
F, G, H, l, J Div. L,2, 3,4,
3. FireZonel234
)Type of Construction
l, ll, ll l, lv, v, v I
f hereby acknorvledge that I have read
this application and state that the
above is correct and agree to comply
with all City Ordinances and State
Laws regulating building construction.
Applicant
BUTLDTNG DEPARTMENT - ClrY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
OF OCCUPANCY
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES
AREA OF LOT
F RONT YARD SETBACK FROM PROP. LINE
SIDE YARD SETBACK FROM PROP. LINE
REAR YARD
Approved: CHIEF BUILDING OFFICAL Approved: ZON ING ADMIN ISTRATOR
PLOT PLAN
PLANNING & ZONING INFO
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TOTAL HT
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CLASS OF WORK
DE MOL ISH
BUILDING ADDRESS
ALTE RAT ION REPA I R
DATE ISSUEDBUILDING PERMIT NO
LOCAL IT Y
ADDIT ION MOVE BLDG. FEE SNEAREST CROSS ST
USE OF BUILDING
SIZE OF BUILDING HE IGHTNAME PLAN CHK. FEE
NO. OF ROOMSMAIL ADDRESS
NO. OF FLOORS
VALUATION
TOTAL
NO. OF BUILDINGS BU!LDING PLUMB!NG ELECTRIC
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3o C ITY TEL. NO
NO. OF BUILDINGS NOW ON LOT FOUNDATI ON ROUGH ROUGH
NO. OF FAMILIES F RAME SEPTIC TANK F IN ISH
SIZE OF LOT PLASTER SEWE R FIXTU RESADDRESS
USE OF BLDG. NOW ON LOT FLUES GAS MOTORSC ITY
SPECIFICATIONS F INAL FITJISH FINAL
FOUNDATION
irtrtU lr,l
F trli=uutrzt'STATE LICENSE NO.
MATE R IAL EXTER IOR.PIERS
NAME
WIDTH OF TOP
WIDTH OF BOTTOMADD R ESS
DEPTH IN GROUND
C ITY
R.W. PLATE (StLL)
SI ZE SPA SPAN
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trFzoU STATE LICENSE NO.
GIRDERS
JOIST lst. FL
JOIST 2nd. FL
SUBDIV ISION
JOIST CEILING
EXTE RIOR STUDS
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LOT NO.BLK.
INTERIOR STUDS
ROOF RAFTERS
BEARING WALLS
COVERING
EXTERIOR WALLS ROOF
INTE RIOR WALLS REROOFING
FLUES
FIREPLACE FL. FURNACI-.
KITCHEN WATER HEATER
FURNACE orLGAS
DO NOT WRITE BELOW THIS LINE
2. Occupancy Group A, B, C, D, E,
F, G, H, l, J Div. I,2, 3, 4,
3. Fire Zone L 23 4
)Type of Construction
l, ll, lll, lv, v, vl
BUtLDTNG DEPARTMENT - CITY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
APPLICATION FOR BUILDING PERMIT AND CERT!FICATE
OF OCCUPANCY
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES
AREA OF LOT
FRONT YARD SETBACK FROM PROP. LINE
SIDE YARD SETBACK FROM PROP. LINE
REAR YARD
Approved: CHIEF BUILDING OFFICAL Approved: ZON lNG ADMIN ISTRATOR
PLOT PLAN
1'no1'
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Ez
m
Y
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oF
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PLANNING & ZONING INFO.
TOTAL HT
f hereby acknorvledge that I have read
this application and state that the
above is correct and agree to comply
with all City Ordinances and State
Laws regulating building construction.
Applicant E). ..By
S
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