ELDERBERRY HGTS BK 1 LT 3 - ZCPKodiak 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
r Submit by Email
IU IIIIIIInllllllllllll
15992
Permit No. CZ2012 -033
Property Owner / Applicant:
Mailing Address:
Phone Number:
Other Contact email, etc.:
Legal Description:
Street Address:
The following information is to be supplied by the Applicant:
James Chong
1815 Selief Lane, Kodiak Alaska 99615
907 - 942 -4040
Lot 3, Block 1, Elderberry Heights
1815 Selief
Use & Size of Existing Structures: Single- family Residential
Description of Proposed Action: Construct 16 by 16 foot deck attached to rear of existing dwelling unit. (unroofed and unenclosed)
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: ZONING: RR -1 PACS_No. 15992
Lot Area: 14,059 square feet Lot Width: 80' Bld'g Height: 35'
Front Yard: 25 ' Rear Yard: 20 ' Side Yard: 10 '
Prk'g Plan Rvw? # of Req'd Spaces:
Plat / Subdivision
Requirements?
NA
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 KIB"
N/A
Coastal Policy Not Applicable
Subd Case No. NA
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
NA
NA
NA
Consistent? Not Applicable Attachment? Not Applicable
Plat No. NA Bldg Permit No. Pending
Applicant Certification: I hereby certify that I will comply with the provisions of the Kodiak Island Borough Code and that 1
have the authority to certify this as the property owner, or as a representative of the property owner. I agree to have identifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments? Site Plan List Other:
Date: Oct 12, 2011
Signature: James Chong, owner or designee
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: A zoning 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 17.03.060. **
CDD Staff Certification
Date: Oct 12, 2011
CDD Staff: Duane Dvorak
Payment Verification
Zoning Compliance Permit Fee
Payable in Cashier's Office
Room # 104
Fee Schedule
Less than 1.75 acres $30.00
Construction Disposal Deposit
Payable in Cashier's Office
Room #104
Fee Sc- edule
OCT 12 2011
Kodiu: bnrougl-
FinancE QQnartma7';
v•
II' - i ¢i a 33'
bEy��6. 4' r� 1,
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- BUILT. SURVEY S�S
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KODIAK ISLAND BOROUGH Community Development
710 Mill Bay Road (Rm 205), Kodiak, Alaska 99615 -6340 - Phone: (907) 486 -9362
ZONING COMPLIANCE PERMIT
Permit #:
FEE: $10.00
CZ- 13 - OW--
.
2.
3.
Property Owner /Applicant: C ao R
) 0 It) O •
Is
If
Number and size of parking spaces required (onsite identification of parking spaces is required - Yes: N • • )
Mailing Address:
C s krie R
(41
'
, �� �= L
Legal Description: L I 3 �% ` /�
l.-.=. )3 �� /2 / /S
Off- street loading requiremen• °�
� i
Street Address: / 3 J 5 EL / may!'
Tax Code #: R I ' 2e) I CO 03
Plat related requirements (e.g., plat notes, easements, subdivision conditions, etc.): ,f.• ' i i &= ` -.1.-..
Description of Existing Propertyicurrentzoning:
Ge
V7(ozSik_ (/. ler) -6.- ..(r • ch SFig—,a,th
Minimum Required Lot Area: 2C))7 vl /
Width:
Other requirements (e.g., zero lot line, additional setbacks, projections into yards, screening, etc.):
Actual Lot Area: ff
��e�$SO L
Width: Q 5— '-7.P�¢`
Minimum Required Setbacks: Sides: / V
11
Front:
Rear:
Coastal Management Program Applicable Polices (check appropriate category) - Residential: Business:
Maximum Building Height: S 5
Industrial: Other (list):
Use and size of existing structures on the lot: R F= S i O I t
1 S f ---- --__)
the proposed action consistent with the KIB Coastal Management Program? - Yes: / ` No:
.
the proposed action conflicts with the Coastal Management Program policies, attach a sheet that notes the policy(ies),
describes the cornetts), and specifies conditions to mitigate the conflict(s). Attachment - Yes: No:
4.
Description of proposed action (attach site plan):
'! 000 `. '
L.. I la< f= 1'0
}
d ti
%1 L D iq 1 A ►l -D D — 0 f'1,, c f !'
.__
A'1
COL) el:?.. :L7
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11
Applicant Certification: I hereby certify that I will comply with the provisions of the Kodiak Isl. Borough Code and that -1 have the authority to certify this as the property owner, or as a representative of the property owner.
. gree to have identifiable corner • rkers in place in the fi - • for verification of setbacks. / 1
l 'f.!/ /A --Tr - ' � 1(Y-7-1, 1 W..,.r i. / ' Date: 2 Y1 / 3 Title: 0000,430
Supporting documents attached (check): Site .. ■
_
ivy -.2 �,— . T� ' oth ( : I
s -built urvey: �1,�r
15:33:03 Duuan0046:,0
PAID
FREE F0Rt1 LIE
Date:' W Title: �� ' _r .4, y:
6.
Community Development staff for zoning, by:
4.1
%.
Fire Chief [City of Kodiak, Fire District #1 (Bayside), Womens Bay Fire District] approval for UFC (Sections 10.207 and 10.301C) by:
Date:
$.
Driveway Permit (State, City of Kodiak, Borough) issued by:
Date:
9. Septic system PLAN approved by: Date:
Distribution: File / Building Official / Applicant/ AssessingTHIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED
July 1992
1 of 1
3 v•PYLti
P1/143
REPLY TO
mmuffmmon
Regulatory Branch
Compliance Section
V-900532
Mr. Lenhart Grothe
Box 1504
Kodiak, Alaska 99615
Dear Mr. Grothe:
DEPARTMENT OF THE ARMY
U.S. ARMY ENGINEER DISTRICT, ALASKA
P.O. BOX 898
ANCHORAGE, ALASKA 99E064898
OCT 1 9 19919
This is a Notice of Violation concerning the placement of fill
material on a tract of property identified as 'Lifts- 1-13, Block 1,?
Elderberry Heights SubdivisiorV, within section 29, T. 27 S., R. 20 W.,
Seward Meridian, on Kodiak Island, Alaska. During an April 24, 1990,
inspection by Messrs. Brad Platt and Jeff Steen of my Compliance Section,
it was discovered that fill material had been placed into approximately
4.1 acres of palustrine emergent wetlands adjacent to Horseshoe Lake. It
has come to our attention that you are the party responsible for this work.
Section 404 of the Clean Water Act requires that a Department of the
Army (DA) permit be obtained prior to discharging dredged and/or fill
material into waters of,the United States, including wetlands. A review
of our file records indicated that the appropriate permit was not
obtained, and is therefore in violation of Section 301 of the Clean Water
Act. Based on the that the lots in question, have been sold to other?
parties, we have-determ4hed-that no enforcemefft action will be taken wit0
respect to-thd-subject04616tioh. Consequently, the file has been closed.
Section 309 of the Clean Water Act provides that any person who
knowingly violates any provision of 33 USC 1311 shall be punished by a
fine of not less than $5,000 nor more than $50,000 per day of violation,
or by imprisonment for not more than three years or both. Future
violations of Section 404 of the Clean Water Act will be considered
knowing and flagrant and may warrant legal action.
You are advised that, if in the future, you plan to discharge dredged
or fill material for any reason into a water of the United States,
including wetlands, you will need to contact this office for a
determination of Department of the Army (DA) jurisdiction and, if
applicable, the required DA authorization. We are enclosing a permit
packet for your convenience.
-2-
Please refer to file number V-900532 should you have any further
questions concerning the above. Questions should be directed to Mr. Platt
of my staff at telephone (907) 753-2712, or FAX number (907) 753-5567, or
at the letterhead address, ATTN: CENPA-CO-R-C.
Sincerely,
Jeffrey K. Towner
Chief, Compliance Section
Enclosures
IMPLY TO
ATTIC...TOON o.
Regulatory Branch
Compliance Section
V-900532
• •
DEPARTMENT OF THE ARMY
US. ARMY ENGINEER DISTRICT, ALASKA
P.O. BOX 898
ANCHORAGE, ALASKA 99506-0898
CERTIFIED
OCT 1 9 1990
Dear Property Owner:
The U.S. Army Corps of Engineers (COE) is responsible for regulating
discharges of dredged and/or fill material into waters of the United
States (U.S.), including wetlands. Pursuant to Section 404 of the Clean
Water Act, a Department of the Army (DA) permit is required prior to the
placement of such material into those waters.
Fill material was placed into waters and wetlands of the U.S. during
the development of LOt-s-1-13, Block 1, Elderberry Heights SubdivisioN
without DA authorization. The work conducted by the developer, Mr.
Lenhart Grothe has resulted in a violation of Section 301 of the Clean
Water Act. Based on the fact that the work in violation on your property
was not performed by you, we have determined that no enforcement action
will be taken with respect to the subject violation.
As property owner, you are advised that, if in the future, you plan to
discharge dredged or fill material for any reason into your lot, you will
need to contact this office for a determination of Department of the Army
(DA) jurisdiction and, if applicable, the required DA authorization.
Future violations of Section 404 of the Clean Water Act on your lot will
be considered knowing and flagrant and may warrant legal action.
Section 309 of the Clean Water Act provides that any person who
knowingly violates any provision of 33 USC 1311 shall be punished by a
fine of not less than $5,000 nor more than $50,000 per day of violation,
or by imprisonment for not more than three years or both.
For informational purposes, copies of this correspondence are being
furnished to the agencies on the enclosed list.
-2-
Please refer to file number V- 900532 should you have any further
questions concerning the above. Questions should be . directed to
Mr. Brad Platt of my staff at telephone (907) 753 -2712, toll free in
Alaska at (800) 478 -2712 or our FAX number (907) 753 -5567, or at the
letterhead address, ATTN: CENPA- CO -R -C.
Sincerely,
Jeffrey K. Towner
Chief, Compliance Section
Enclosures
TO: CITY OF KODIAK
P.O.BOX 1397
KODIAK, ALASKA 99615
AP. CATION FOR CERTIFICATE OF REGIS .TION
(SALES AND SERVICE TAX)
DATE OF APPLICATION
ACCOUNT NO.
NAME OF Fl RM
LOCATION ADDRESS
0 .
•siA,OZ C PS C
-KostL,;1--■
LO( 3 i94e_
LIUr
MAILING ADDRESS \ 8)5 c -
STREET
BUSINESS PHONE e? - 73
CITY
NAME OF OWNER <-(1' og,.) k
r
HOME ADDRESS
JF/.5 SZ• /(-1/
TATE ZIP CODE
/(1)14 /7/(
TYPE OF BUSINESS
STREET CITY STATE
( /- iur ,f2c/x72
ZIP CODE
HOME PHONE "i7
DATE BUSINESS STARTED
/4/
ALASKA BUSINESS LICENSE NUMBER
TYPE OF ORGANIZATION:
0 Ni-kk-l`C
INDIVIDUAL
PARTNERSHIP
CORPORATION
OTHER (EXPLAIN BELOW)
IS BUSINESS SEASONAL IF YES, APPROXIMATE DATES THAT BUSINESS IS OPERATED EACH YEAR
Z-0 t./ZA16 /5 g..02 I. 1,e5E /1/9'
-4 if4i7I FROM _TO NO. OF MONTHS
/3A-S6---- d-,3 ..1.7x-Jrc.)
/1,v7 47t4
SIGNATURE & TITLE OF APPLICANT
NAME /2 /OA/ Li 6--. - /,.-Plf. TITLE Co /4 /i/e
MAILING ADDRESS: 1PV.-( ,r/r/f/Cf LAI leiJ / I" HOME ADDRESS: li-/ ...Y.- ....i7 t-,/, ,.., PHONE:
NAME / r if
/V, /ti 7,01)16 f . TITLE (10
MAILING ADDRESS: il7 (7 ./..v2/A,A7 (dAy /J/c" HOME ADDRESS: /6 / 5- 2 V/4-4//4/ PHONE: qii....) '-'
NAME TITLE
0.4AILING ADDRESS: HOME ADDRESS: PHONE:
NAME TITLE
1 MAILING ADDRESS: HOME ADDRESS: PHONE:
REVENUE OFFICE
BUILDING DEPARTMENT — CITY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
CLASS OF WORK
ITV
NEW
DEMOLI51
ALTERATION
REPAIR
ADDITION
MOVE
USE OF BUILDING
NAME
ADDRESS
CITY
STATE LICENSE NO.
SIZE OF BUILDING HEIGHT
NO. OF ROOMS
NO. OF FLOORS
NO. OF BUILDINGS
O. OF BUILDINGS NOW ON LOT
NO. OF FAMILIES
SIZE OF LOT
USE OF BLDG. NOW ON LOT
SPECIFICATIONS
FOUNDATION
J
Q
w
J
CITY
STATE LICENSE NO. n
,_ pL
LOT NO
BL K.
DO NOT WRITE BELOW THIS LINE
Type of Construction
I, II, Ill, IV, V, VI
2. Occupancy Group A, B, C, D, E,
F, G, H, I, J Div. 1, 2, 3, 4,
3. Fire Zone 1 2 3 4
MATERIAL
EXTERIOR,
PIERS
WIDTH OF TOP
WIDTH OF BOTTOM
DEPTH IN GROUND
R.W. PLATE (SILL)
SIZE SPA.,
GIRDERS
JOIST 1st. FL.
JOIST 2nd. FL
JOIST CEILING
EXTERIOR STUDS
INTERIOR STUDS
ROOF RAFTERS
BEARING WALLS
COVERING
EXTERIOR WALLS
ROOF
INTERIOR WALLS REROOFING
FLUES
FIREPLACE FL. FURNACE
KITCHEN WATER HEATER
URNACE
GAS OIL
I hereby acknowledge 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 buildi'g construction.
Applicant
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
OF OCCUPANCY
DATE ISSUED
BUILDING PERMIT NO.
VALUATION
S
BUILDING
FOUNDATION
FRAME
PLASTER
FLUES
FINAL
BLDG. FEE /
PLAN CHK. FEE
TOTAL
PLUMBING
ROUGH
SEPTIC TANK
SEWER
GAS
FINISH
$1
ELECTRIC
ROUGH
FINISH
FIXTURES
MOTORS
FINAL
3N1-1 A1.83dOad
A
PLOT PLAN
SETBACK
3N11 Ala3dOad
STREET
PLANNING Be ZONING INFO.
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES TOTAL HT.
AREA OF LOT
FRONT YARD SETBACK FROM PROP. LINE
SIDE YARD SETBACK FROM PROP. LINE_
REAR YARD
Approved: CHIEF BUILDING OFFICAL Approved: ZONING ADMINISTRATOR
By: By:_
BUILDING DEPARTMENT—CITY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
CLASS OF WORK
BUILDING ADDRESS
NEW
DEMOLISH
LOCALITY
NEAREST CROSS ST.
NAME
C
MAIL ADDRESS
0
ALTERATION
REPAIR
w w W
F w
= Z
U
Z
w
0
I-
U
IY
F
2
0
0
CITY
TLL. NO.
NAME
ADDRESS
CITY
STATE LICENSE NO.
NAME
2i
0
J a.
▪ a
E
W U
M
W
0
ADDITION
MOVE
USE OF BUILDING
SIZE OF BUILDING HEIGHT
NO. OF ROOMS
NO. OF FLOORS
NO. OF BUILDINGS
NO. OF BUILDINGS NOW ON LOT
NO. OF FAMILIES ?
SIZE OF LOT
USE OF BLDG. NOW ON LOT
SPECIFICATIONS
FOUNDATION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
OF OCCUPANCY
BUIL. DING PERMIT NO.
MATERIAL
EXTERIOR,
PIERS
ADDRESS
CITY
STATE LICENSE NO.
SUBDIVISION
LOT NO. BLK.
WIDTH OF TOP
WIDTH OF BOTTOM
DEPTH IN GROUND
R.W. PLATE (SILL)
SI /I
SPA._
SPAN
GIRDERS
JOIST 151. FL.
JOIST 2nd. FL
JOIST CEILING
VALUATION
BUILDING
FOUNDATION
FRAME
PLASTER
FLUES
FINAL
DO NOT WRITE BELOW THIS LINE
,Type of Construction
I, II, III, IV, V, VI
2. Occupancy Group A, B, C, D, E,
F, G, H, I, J Div. 1, 2, 3, 4,
3. Fire Zone 1 2 3 4
EXTERIOR STUDS
INTERIOR STUDS
ROOF RAFTERS
BEARING WALLS
COVERING
EXTERIOR WALLS
ROOF
INTERIOR WALLS
REROOFING
FLUES
FIREPLACE FL. FURNACE
KITCHEN WATER HEATER
FURNACE
GAS Olt
I hereby acknowledge 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
--a
DATE ISSUED
i� ,
BLDG. FEE
PLAN CHK. FEE
TOTAL
PLUMBING
ROUGH
SEPTIC TANK
SEWER
GAS
FINISH
i -Ia
Approved: CHIEF BUILDING OFFICAL
By:
ELECTRIC
ROUGH
FINISH
FIXTURES
MOTORS
FINAL
3N11 A183dOHd
A
PLOT PLAN
H
SETBACK
3N11 AkN3dOad
STREET
PLANNING & ZONING INFO.
ZONING DISTRICT i
TYPE OF OCCUPANCY
NUMBER OF STORIES TOTAL HT.
AREA OF LOT
FRONT YARD SETBACK FROM PROP. LINE
SIDE YARD SETBACK FROM PROP. LINE
REAR YARD
Approved: ZONING ADMInIrcTOATnn
3NI1 A183dO2id
BUILDING DEPARTMENT— CITY / BOROUGH OF KODIAK APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
Applicant to fill in between heavy lines. OF OCCUPANCY
BUILDING ADDRESS
CLASS OF WORK
NEW
DEMOLISH
LOCALITY
ALTERATION
REPAIR
NEAREST CROSS ST.
ADDITION
MOVE
USE OF BUILDING (i7 jX r
NAME
• MAIL ADDRESS
3
O CITY
CHITECT
ENGINEER
CONTRACTOR
DESCRIPTION
TEL. NO.
NAME
ADDRESS
CITY
STATE LICENSE NO.
NAME
SIZE OF BUILDING 171420..., / (..
HEIGHT
NO. OF ROOMS
NO. OF FLOORS
NO. OF BUILDINGS
NO. OF BUILDINGS NOW ON LOT
NO. OF FAMILIES
C—
SIZE OF LOT /9 G s-,/,
1//7
USE OF BLDG. NOW ON LOT
SPECIFICATIONS
FOUNDATION
MATERIAL
EXTERIOR,
PIERS
WIDTH OF TOP
ADDRESS
WIDTH OF BOTTOM
CITY
STATE LICENSE NO.
SUBDIVISION
LOT NO.
BLK.
DO NOT WRITE BELOW THIS LINE
10. Type of Construction
I, II, III, IV, V, VI
2. Occupancy Group A, B, C, D, E,
F, G, H, I, J Div. 1, 2, 3, 4,
3. Fire Zone 1 2 3 4
DEPTH IN GROUND
R.W. PLATE (SILL)
SIZE
SPA..
SPAN
GIRDERS
JOIST 1st. FL.
JOIST 2nd. FL
JOIST CEILING
EXTERIOR STUDS
INTERIOR STUDS
ROOF RAFTERS
BEARING WALLS
COVERING
EXTERIOR WALLS
ROOF
INTERIOR WALLS REROOFING
FLUES
FIREPLACE FL. FURNACE
KITCHEN WATER HEATER
FURNACE
GAS OIL
I hereby acknowledge 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
BUILDING PERMIT NO.
VALUATION
BUILDING
FOUNDATION
FRAME
PLASTER
FLUES
FINAL
DATE ISSUED
BLDG. FEE
PLAN CHK. FEE
TOTAL
PLUMBING
ROUGH
SEPTIC TANK
SEWER
GAS
FINISH
ELECTRIC
ROUGH
FINISH
FIXTURES
MOTORS
FINAL
A
PLOT PLAN
i•C
SETBACK
3NI1 A1213dOiid
STREET
PLANNING & ZONING INFO
ZONING DISTRICT _- L=, ri (� 4. /($,
TYPE OF OCCUPANCY
NUMBER OF STORIES
AREA OF LOT /e..-1/ ' - /
FRONT YARD SETBACK FROM PROP. LINE A} C -- *
TOTAL HT. /
SIDE YARD SETBACK FROM PROP. LINE „,./e;: ▪ �.'24" `
REAR YARD
Approved: CHIEF BUILDING OFFICAL Approved: ZONING ADMINISTRATOR
By: By. / /,, ;) ;2 /f' j` �-
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY - CITY OF KODIAK - KODIAK ISLAND BOROUGH - BUILDING DEPARTMENT
Telephone: 486 -8070 710 Mill Bay Road
(APPLICANT TO FILL IN ALL INFORMATION WITHIN BOLD LINES. PLEASE PRINT. USE A BALLPOINT PEN AND PRESS FIRMLY.)
(OFFICE USE ONLY)
STREET ADDRESS:
CLASS AND SCOPE OF WORK
SPECIFICATIONS:
BUILDING PERMIT NUMBER:
DATE OF APPLICATION:
LOT: ,„ BLOCK:
NEW
DEMOLITION
FOUNDATION
FOOTINGS
STEM WALL
PIERS
ZONING COMPLIANCE:
DATE ISSUED:
ALTERATION
REPAIR
TYPE
SUBDIVISION / SURVEY:
�, 4- is ? �r
ADDITION
MOVE
DIMENSIONS
VALUATION BASIS:
BUILDING PERMIT FEE:
DEPTH IN GRND
O
I W
NCITY
R
NAME
e. c 00 /l/
USE OF BUILDING AUTHORIZED BY
THIS PERMIT:
REINFORCEMENT
VALUATION:
PLAN CHECK FEE:
BOLT SPACING
CRAWL SPACE HEIGHT :•j f„,:)" INCHES
OCCUPANCY GROUP:
TOTAL FEE:
MAILING ADDRESS:
A B E H I M('R
DIV. 1 2 3 4 5 6
CRAWL SPACE VENT SQ. FEET
& STATE:
SIZE HEIGHT
STRUCTURAL
SPECIES & GRADE
SIZE
SPACING
SPAN
NO. OF ROOMS STORIES
RECEIPT NO:
TELEPHONE:
NO. OF FAMILIES
GIRDERS
EACH OF THE FOLLOWING
STAGES OF CONSTRUCTION
REQUIRES INSPECTION BE
REQUESTED & COMPLETED
PRIOR TO PROCEEDING WITH
ANY FURTHER WORK:
FOR INSPECTION CALL 486 -8070
TYPE OF BUSINESS
GIRDERS
A
R
C
HCITY
E
N
G
I
NAME:
NO. OF BLDGS NOW ON LOT
JOISTS 1ST FLOOR
ft t.----.' iith
USE OF EXISTING BLDGS
JOISTS 1ST FLOOR
MAILING ADDRESS:
SIZE OF LOT
JOISTS 2ND FLOOR
WATER: PUBLIC
PRIVATE
JOISTS 2ND FLOOR
TYPE OF CONSTRUCTION
I II III IV V
N 1-HR FR H.T.
& STATE:
SEWER: PUBLIC
PRIVATE
CEILING JOISTS
INSULATION TYPE & THICKNESS:
EXTERIOR WALLS
BEARING WALLS
TELEPHONE:
FOUNDATION
INTERIOR WALLS
EXCAVATION
STATE LICENSE:
WALLS
ROOF RAFTERS
UNDERGROUND UTILITIES
ROOF / CEILING
TRUSSES
DRIVEWAY PERMIT:
FOUNDATION / SETBACKS
SUBMITTED
FRAMING
C
NMAILING
T
R
A
C
0
R
NAME:
— ( r� _ • /__.
4°' = i
SHEATHING TYPE & SIZE;
FURNACE TYPE:
r j
FLOOR' i`1'�" I) -Y
APPROVED
ROUGH ELECTRICAL
WOOD HEATER YES NO
TYPE
ROUGH PLUMBING
ADDRESS:
ADEC APPLICATION:
FINAL
DATE C.O. ISSUED:
WALLS I t / i
SUBMITTED
CITY & STATE:
ROOF 1"a1 -- `1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION,
THAT IT IS CORRECT AND THAT I AGREE TO COMPLY WITH ALL
ORDINANCES AND LAAWS�REGULLATTIIN�G BUILDING CONSTRUCTION
A�lF- 7
APPLICANT: �\2e-J - ) -'� `6� / j
FINAL APPROVAL
ALASKA FIREMARSHAL REVIEW:
SUBMITTED: APPROVED:
TELEPHONE:
FINISH MATERIAL:
_
ROOF (.001. r�
APPROVED - BUILDING OFFICIAL:
STATE LICENSE:
EXTERIOR SIDING '7 7 /
INTERIOR WALLS _ /A j ,,..
NOTES:
UTILITY CONNECTION FEE
WATER $ DATE
SEWER $ RECEIPT #
TOTAL $ CASHIER