USS 3218 COMM TR 1 OF TR S-5A-1 - ZCP 10/18/2012Kodiak Island Borough
Community Development Department
710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9362 Fax (907) 486 - 9396
http://www.kodiakak.us
Zoning Compliance Permit
Print Form
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Submit by Email
Permit No. C2 _r 3
Property Owner / Applicant:
Mailing Address:
Phone Number:
Other Contact email, etc.:
Legal Description:
Street Address:
Use & Size of Existing Structures:
The following information is to be supplied by the Applicant:
Safeway Inc.
1121 124th NE Bellevue WA 98005
425 - 201 -6420
Shei Kai
Subdv: USS 3218 TR S -5A -1 TR1
2685 Mill Bay Road
Block: Lot:
Grocery Store
Description of Proposed Action: Remodel of existing pharmacy to add a second consultation room.
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Site Plan to include: Lot boundaries and existing easements, existing buildings, proposed location of new construction, access
points, and vehicular parking areas.
Staff Compliance Review:
Current Zoning: Business KIBC 17.90 PROP ID 16353
Lot Area: Lot Width:
Front Yard: Not Applicable
Bld'g Height: 50'
Rear Yard: Not Applicable Side Yard: Not Applicable
Prk'g Plan Rvw? Not Applicable # of Req'd Spaces:
Plat / Subdivision
Requirements?
Does the project involve If YES, do you have an EPA Return Receipt of Notification?
an EPA defined facility? N / A "Permit will not be issued until receipt is submitted to K/B"
Subd Case No. Plat No.
Driveway
Permit?
Septic Plan
Approval:
1-
Fire
Marshall:
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Bld'g Permit No. T
Applicant Certification: 1 hereby certify that 1 will comply with the provisions of the Kodiak Island Borough Code and that I
have the authority to certify this as the property owner, or as a representative of the property owner. 1 agree to have identifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments? Other List Other: Floor Plan
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Date: Oct 18, 2012 Signature: Ed Warner .—;p ,r"4
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This permit is only for the proposed project as described by the applicant. If there are any changes to the
proposed project, including its intended use, prior to or during its siting, construction, or operation, contact
this office immediately to determine if further review and approval of the revised project is necessary.
** EXPIRATION: Azoning compliance permit will become null and void if the building or use authorized by such permit is not
commenced within 180 days from the date of issuance, or if the building construction or use is abandoned at any time, after the
work is commenced, for a period of 180 days. Before such work can be recommenced, a new permit must first be obtained. (Sec.
106.4.4 Expiration. 1997 UBC) per KIBC 17.7 5.060 A. **
CDD Staff Certification
Date: Oct 18, 2012 CDD Staff: Martin Lydick
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Room #104- Main floor of Borough Building
After - the -Fact 2X the published amount
Not Applicable F $0.00 �i� /, f r $0.00
Less than 1.75 acres: $30.00 /Ulf(- $60.00
1.76 to 5.00 acres: F- $60.00 r $120.00
5.01 to 40.00 acres: r $90.00 Pp t� r $180.00
40.01 acres or more: r $120.00 VEB 2S 2013 r $240.00
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March 5. 201: SAFEWAY
Kodiak Island Borough Community DeN clopment Department
Re: Kodiak Safeway 1040 Pharmacy Remodel
Dear Building Official.
This letter is our authorization for Ed Warner of Elite Construction to obtain the
pharmaeN remodel permit for this project in Kodiak.
Please let me know if you require any additional verbiage or modifications to this letter.
Thank you,
Brian North
Construction Project Manager
Btian.north a safcNca%.cum
(30_) 657-6486
r�' rB�'VED
MAR - 6 2013
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Safeway Inc.
Portland Omsion
Cwslulion Department
P.O. Box 1564
Clackamas OR 97015