ESTELLE LT 3A - Supplemental InformationGAS cell
BUILDING DEPARTMENT — CITY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
CLASS OF WORK
BUIL'.:
NEW
DEMOLISH
LOCALITY
ALTERATION
REPAIR
NEAREST CROSS ST.
ce
Z
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NAME
MAIL ADDRESS
CITY TEL. NO.
NAME
ADDRESS
0
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1-
N
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DESCRIPTION
CITY
STATE LICENSE NO.
NAME
ADDRESS
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
MATERIAL
EXTERIOR,
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
OF OCCUPANCY
BUILDING PERMIT NO.
VALUATION
BUILDING
WIDTH OF TOP
CITY
WIDTH OF BOTTOM
STATE LICENSE NO.
SUBDIVISION
LOT NO.
B L K.(!
DO NOT WRITE BELOW THIS LINE
Ilk. 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
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
FOUNDATION
FRAME
PLASTER
FLUES
FINAL
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
DATE ISSUED
C�-
BLDG. FEE
PLAN CHK. FEE
TOTAL
PLUMBING
ROUGH
SEPTIC TANK
SEWER
GAS
FINISH
o
ELECTRIC
ROUGH
FINISH
FIXTURES
MOTORS
FINAL
3N11 Al2i3dO8d
PLOT PLAN
A
SETBACK
3N11 Al2j3dOad
STREET
PLANNING & ZONING INFO.
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES 101 AL H 7.
AREA OF LOT l
FRONT YARD SETBACK FROM PROP. LINE
SIDE YARD SETBACK FROM PROP. LINE
REAR YARD
Approved: CHIEF BUILDING OFFICAL Approved: ZONING ADMINISTRATOR
By:
By: