KODIAK TWNST BK 1 LT 2 & 3 - Building PermitBUILDING DEPARTMENT - KODIAK ISLAND BOROUGH APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
(APPLICANT TO FILL IN ALL INFORMATION WITHIN HEAVY LINES. PLEASE PRINT, USE BALL-POINT PEN, AND PRESS FIRMLY.)
SUBDIVISION/SURVEY CLASS AND SCOPE OF WORK 1 BUILDING PERMIT NUMBER DATE ISSUED
LOT NO.
BLOCK NO.
STREET ADDRESS
NEW
DEMOLISH
ALTERATION
REPAIR
ADDITION
MOVE
USE OF BUILDING
SIZE OF BUILDING HGT
NEAREST CROSS STREET
NO. OF ROOMS
NO. OF FAMILIES
FLOORS
W
Z
O
NAME yy
i;1 Y !1 F.. �: •.
MAILING ADDRESS
-�5:-
NO. OF BUILDINGS NOW ON LOT
USE OF BUILDINGS
SIZE OF LOT
VALUATION: (BASIS)
AMOUNT
BLDG PERMIT REE
PLAN CHK FEE
TOTAL
INSPECTION SCHEDULE
BUILDING
PLUMBING
CITY, STAT
I-
U
W W
z
S �
w
NAME
ADDRESS
TELcPHONE
WATER: PUBLIC
SEWER. PUBLIC
PRIVATE
PRIVATE
FOUNDATION
FRAME
ROUGH
SEPTIC TANK
ELECTRICAL
ROUGH
FINISH
SPECIFICATIONS
PLASTER/BD
SEWER
FIXTURES
FOUNDATION
TYPE
DEPTH IN GND
HGT FIN GRADE
CITY, STATE
P.T. PLATE (SILL)
EXT
PIERS
FLUES
GAS
MOTORS
STRUCTURAL
SIZE
FINAL
FINISH
FINAL
SPA.
SPAN
STATE LICENSE NO.
GIRDERS
JOISTS 1ST FLR.
EACH OF THE ABOVE INSPECTIONS MUST BE REQUESTED AND THAT
WORK APPROVED PRIOR TO ANY ADDITIONAL WORK PROGRESSING
BEYOND THAT POINT, AS REQUIRED BY UBC SECTION 305. FOR EACH
INSPECTION, 24 HOURS NOTICE IS REQUIRED. TELEPHONE THE KODIAK
ISLAND BOROUGH ENGINEERING DEPARTMENT, 486-5736, EXT. 273.
NOTES:
INSTALLATION OF (MINIMUM) 18 -INCH BV 20 -FOOT CULVERT IS REQUIRED
AT EACH DRIVEWAY ACCESS TO THE PROPERTY.
CONTRACTOR
NAME
JOISTS 2ND FLR.
JOISTS CLG
ADDRESS
EXT STUDS
INT STUDS
CITY, STATE
ROOF RAFTERS
TRUSSES
STATE LICENSE NO.
BEARING WALLS
INSULATION, FNDN
(FOR OFFICE USE ONLY: CIRCLE)
1. OCCUPANCY GROUP
ABEHIMR
DIVISION 1 2 3 4 5
2. TYPE OF CONSTRUCTION
I II III IV V
FR 1-14R. N H.T.
WALLS ROOF/CLG
SHEATHING, WALLS/EXT
ROOF FLOOR
FINISH, EXT WALLS
ROOF
FLUES, FIREPL WOOD HTR
KITCHEN WATER HTR
FURNACE, TYPE
I HEREBY ACKNOWLEDGE THAT I HAVE
READ THIS APPLICATION, THAT IT IS
CORRECT, AND THAT I AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS
REGULATING BUILDING CONSTRUCTION.
APPLICANT
SANITATION PLAN APPROVAL BY AN ADEC-CERTIFIED INSTALLER I5
REQUIRED PRIOR TO ISSUANCE OF A BUILDING PERMIT WHERE PUBLIC
WATER AND/OR SEWER IS NOT AVAILABLE FROM A CERTIFICATED
MUNICIPAL SYSTEM.
PLOT PLAN
(A SITE PLAN MAY ALSO BE REQUIRED)
REAR PROPERTY LINE
SIDE PROPERTY LINE
FRONT PROPERTY LINE
STREET
SIDE PROPERTY LINE
INSTALLER'S PLAN APPROVAL RECEIVED NOTE: APPLICANT SHALL SHOW BUILDING SETBACKS
FROM PROPERTY LINES, AS PERPENDICULAR DISTANCES
INSTALLER FROM PROPERTY LINES TO BUILDING. DIMENSIONS OF
PRIOR TO THE ISSUANCE OF A PERMIT, EITHER THE OWNER OF THE STRUCTURE SHALL BE SHOWN ON THE PLAN.
PROPERTY OR HIS AUTHORIZED AGENT MUST SIGN THIS APPLICATION OR
GRANT OTHER WRITTEN PERMISSION FOR THE DESCRIBED WORK TO BE
PERFORMED.
TAX LOT NO DATE
OWNER PER
OWNERSHIP TRANSFERRED, IN PROCESS, TO:
PE R
CLOSING DATE, DEED RECORDED (BV)
APPROVED, BUILDING OFFICIAL
BY
ZONING
TYPE 0
NO. 0
AREA
SETB
FR
SI
REQ
ZONING CODE COMPLIANCE
OFF-STREET PARKING
C.U.P. OR VARIANCE r
APPROVED, ZONING OFFICER-
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
BUILDING PERMIT NO.
DATE ISSUED
USE OF BUILDING
IY
w
Z
0
NAME
SIZE OF BUILDING HEIGHT
MAIL ADDRESS
NO. OF ROOMS
NO. OF FLOORS
CITU TEL NO
NO. OF BUILDINGS
VALUATION
$
BLDG. FEE
PLAN CHK. FEE
TOTAL
U C'
w w
• w
_ Z
r O
• Z
Q w
NAME
NO. OF BUILDINGS NOW ON LOT
BUILDING
PLUMBING
ELECTRIC
NO. OF FAMILIES
FOUNDATION
ROUGH
ROUGH
ADDRESS
SIZE OF LOT
FRAME
SEPTIC TANK
FINISH
LITY
PLASTER
SEWER
FIXTURES
SPECIFICATIONS
LUf S
GAS
MOTORS
STATE LICENSE NO.
FOUNDATION
FINAL
FINISH
FINAL
CONTRACTOR
NAME
MATERIAL
EXTERIOR. PIERS
WIDTH OF TOP
ADDRESS
WIDTH OF BOTTOM
CITY
DEPTH IN GROUND
R . PLATE (SILL)
STATE LICENSE NO.
SIZE
SPA.,
SPAN
J
0
w
-J
DESCRIPTION
SUBDIVISION
GIRDERS
JOIST 1st. FL.
JOIST 2nd. FL.
LOT NO. BLK.
JOIST CEILING
EXTERIOR STUDS
DO NOT WRITE BELOW THIS LINE
Type of Construction
I, 11, 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
INTERIOR STUDS
ROOF RAFTERS
BEARING WALLS
COVERING
EXTERIOR WALLS 1 ROOF
INTERIOR WALLS REROOFING
FLUES
FIREPLACE FL. FURNACE
KITCHEN WATER HEATER
I URNACE
GAS 011
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
3N11 A183dO2id
SETBACK
STREET
PLANNING & ZONING INFO.
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES I OTAL 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 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
Applicant to fill in between heavy lines. OF OCCUPANCY
BUILDING .,DDRE SS
CLASS OF WORK
NEW
DEMOLISH
LOCALITY
ALTERATION
REPAIR
NEAREST CROSS ST.
cc
Z
0
/
NAM/ //l'1�/7 I ..)/50,4 I////.I‘7
ADDITION
MOVE
BUILDING PERMIT NO.
DATE ISSUED
USE OF BUILDING
SIZE OF BUILDING z i
HEIGHT /u
MAIL ADDRE5"-y 22 �
NO. OF ROOMS
NO. OF FLOORS
CITUL../ Nx/ q/,TE O �
NAME
NO. OF BUILDINGS
NO. OF BUILDINGS NOW ON LOT /
VALUATION
$
BLDG. FEE
PLAN CHK. FEE
TOTAL
BUILDING
PLUMBING
ELECTRIC
NO. OF FAMILIES
ADDRESS
SIZE OF LOT
e
FOUNDATION
ROUGH
ROUGH
FRAME
SEPTIC TANK
FINISH
V
PLASTER
SEWER
FIXTURES
SPECIFICATIONS
JE S
GAS
STATE LICENSE NO.
FOUNDATION
INAL
FINISH
MOTORS
FINAL
CONTRACTOR
NAME
ADDRESS
MATERIAL
EXTERIOR.
PIERS
WIDTH OF TOP
WIDTH OF BOTTOM
CITY
DEPTH IN GROUND
R.W. PLATE (SILL)
STATE LICENSE NO.
SIZE
SPA.,
SPAN
Z
J 0
a a
oc
w U
J N
0
SUBDIVISION
/&R -l( A-4 /- ).
GIRDERS
JOIST 1st. FL.
JOIST 2nd. FL.
LOT NO.
3
BLK.
JOIST CEILING
EXTERIOR STUDS
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
INTERIOR STUDS
ROOF RAFTERS
BEARING WALLS
COVERING
EXTERIOR WALLS
ROOF
INTERIOR WALLS REROOFING
FLUES
FIREPLACE FL. FURNACE
KITCHEN WATER HEATER
FURNACE
GAS 011
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
ZONING DISTRICT
3N11 AJ l3dO2id
A
PLOT PLAN
SETBACK
3N11 Al2:13dO2jd
STREET
�. y
/C/
4 x3e)' c.,1 74- /) at.ctpj.7, 9
/7112p/77m.W k __ G/ r
¢c,/"—i)
PLANNING & ZONING INFO.
TYPE OF OCCUPANCY T7 --Z /VD 44., . c:.s , 'K
NUMBER OF STORIES /S// A? . TOTAL IFT. S/ x 3l /
AREA OF LOT 7 y p
FRONT YARD SETBACK FROM PROP. LINE A
•6
SIDE YARD SETBACK FROM PROP. LINE
REAR YARD
Approved: CHIEF BUILDING OFFICAL A
pp Approved: ZONING ADMINISTRATOR
By: