KODIAK TWNST BK 1 LT 25 - 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
NEW
DEMOLISH
LOT NO. BLOCK NO.
ALTERATION
ADDITION
REPAIR
MOVE
STREET ADDRESS
4 1.-�
USE OF BUILDING
BUILDING PERMIT NUMBER
VALUATION: (BASIS)
DATE ISSUED
BLDG PERMIT FEE
G i)
NEAREST CROSS STREET
NAME
P'tArII (L.1..
w MAILING ADDRESS
Z
.
0 CITY, STATE TELEPHONE SEWER: PUBLIC
\_-- c. G' !fit L t h L 'g�t" -'). LECIFICATIONS
SIZE OF BUILDING
NO. OF ROOMS
NO. OF FAMILIES
NO. OF BUILDINGS NOW ON LOT
HGT
FLOORS
AMOUNT
PLAN CHK FEE
TOTAL
USE OF BUILDINGS
SIZE OF LOT
WATER: PUBLIC
NAME
PRIVATE
INSPECTION SCHEDULE
BUILDING
PLUMBING
ELECTRICAL
PR IVATE
FOUNDATION
FRAME
ROUGH
SEPTIC TANK
ROUGH
FINISH
PLASTER/BD
SEWER
FIXTURES
FOUNDATION
TYPE
ADDRESS
CITY, STATE
STATE LICENSE NO.
EXT
PIERS
DEPTH IN GND
HGT FIN GRADE
FLUES
GAS
MOTORS
FINAL
FINISH
FINAL
P.T. PLATE (SILL)
STRUCTURAL
GIRDERS
JOISTS 1ST FLR.
SIZE
SPA.
SPAN
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 4865736 EXT. 273.
NOTES:
INSTALLATION OF (MINIMUM) 18 -INCH BY 20 -FOOT CULVERT IS REQUIRED
AT EACH DRIVEWAY ACCESS TO THE PROPERTY.
010.'mn."
CONTRACTOR
NAME
JOISTS 2ND FLR.
JOISTS CLG
ADDRESS
EXT STUDS
INT STUDS
CITY, STATE
STATE LICENSE NO.
ROOF RAFTERS
TRUSSES
BEARING WALLS
INSULATION, FNDN
(FOR OFFICE USE ONLY: CIRCLE)
1. OCCUPANCY GROUP
A BEH IM R
DIVISION 1 2 3 4 5
2. TYPE OF CONSTRUCTION
I II III IV V
FR 1 -HR. N H.T.
WALLS ROOF/CLG
SHEAJHING, WALLS/EXT
ROOF FLOOR
SANITATION PLAN APPROVAL BY AN ADEC-CERTIFIED INSTALLER IS
REQUIRED PRIOR TO ISSUANCE OF A BUILDING PERMIT WHERE PUBLIC
WATER AND/OR SEWER 15 NOT AVAILABLE FROM A CERTIFICATED
MUNICIPAL SYSTEM.
INSTALLER'S PLAN APPROVAL RECEIVED
PLOT PLAN
(A SITE PLAN MAV ALSO BE REQUIRED)
REAR PROPERTY LINE
SIDE PROPERTY LINE
FRONT PROPERTY LINE
SIDE PROPERTY LINE
STREET
NOTE: APPLICANT SHALL SHOW BUILDING SETBACKS
INSTALLER FROM PROPERTY LINES, AS PERPENDICULAR DISTANCES
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:
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.
APPU ANT
CLOSING DATE, DEED RECORDED
PER
(BY)
APPROVED, BUILDING OFFICIAL
ZONING CO ' E COMPLIANCE
ZONING DISTRICT
TYPE;)F_ OCCUPANCY
NO. C.1!F -TORIES
AREA OF OT
SETBACKS ROM PROPE
F CONT
SDE(L)
REAR(/;
AL HGT
RE 'D OFF-STR
C.UIP. OR VARIAN
T PA
SIDEpR)
KING
%aF
APPROVED, ZONING OFFICER `J
BUILDING DEPARTMENT — CITY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
CLASS OF WORK
BUILDING ADDRESS
LOCALITY
NEAREST CROS
w
w
Z
0
w w
— z
0
Z
w
NAME
NEW
DEMOLISH
ALTERATION
REPAIR
MAIL ADDRESS
CITY it L. N9.
ADDITION
MOVE
USE OF BUILDING
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
J
0
J
STATE LICENSE NO.
ADDRESS
CITY
STATE LICENSE NO.
SUBDIVISION
LOT NO.
BLK.
USE OF BLDG. NOW ON LOT
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
OF OCCUPANCY
BUILDING PERMIT NO.
VALUATION
BUILDING
0UNUA1 10N
FRAME
PI ASTFR
DATE ISSUED
BLDG. FEE
PLAN CHK. FEE
TOTAL
PLUMBING
ROUGH
SEPTIC TANK
SEWER
5
ELECTRIC
ROUGH
FINISH
FIXTURES
SPECIFICATIONS
FOUNDATION
MATERIAL
EXTERIOR,
PIERS
WIDTH OF TOP
WIDTH OF BOTTOM
DEPTH IN GROUND
R.W. PLATE (SILL)
slzE
SPA_
SPAN
GIRDERS
JOIST 1st. FL.
JOIST 2nd. FL.
JOIST CEILING
UI S
NAL
EXTERIOR STUDS
DO NOT WRITE BELOW THIS LINE
M. 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
ROOF
INTERIOR WALLS REROOFING
FLUES
FIREPLACE FL. FURNACE
KITCHEN WATER HEATER
I 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 building -construction.
Applicant
GAS
FINISH
MOTORS
FINAL
!_'.JL
1?
Approved: CHIEF BUILDING OFFICAL
3N11 A1H3dO21d
PLOT PLAN
3N11 Al2j3dO8d
SETBACK
STREET
PLANNING & ZONING INFO.
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES 3 TOTAL HT.
AREA OF LOT
FRONT YARD SETBACK FROM PROP. LINE
SIDE YARD SETBACK FROM PROP. LINE
REAR YARD
Approved: ZONING ADMINISTRATOR
By: By.
BUILDING DEPARTMENT — CITY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
CLASS OF WORK
BUILDING ADDRESS
LOCALITY
NEAREST CROSS ST.
cc
w
w
Z
0
J
D
J
NAME
MAIL ADDRESS
CITY TFL. NO.
W
DEMOLISH
LTERATION
REPAIR
f [EDITION
MOVE
SE OF BUILDING
SIZE OF BUILDING HEIGHT
NO. OF ROOMS
NO. OF FLOORS
NO. OF BUILDINGS
NO. OF BUILDINGS NOW ON LOT
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
OF OCCUPANCY
BUILDING PERMIT NO.
VALUATION
BUILDING
DATE ISSUED
BLDG. FEE
PLAN CHK FEE
TOTAL
PLUMBING
STATE LICENSE NO.
NAME
ADDRESS
CITY
STATE LICENSE NO.
SUBDIVISION
LOT NO. BLK.
NO. OF FAMILIES
SIZE OF LOT
ift I UT
FOUNDATION
FRAME
PLASTER
ROUGH
SEPTIC TANK
SEWER
S
ELECTRIC
ROUGH
FINISH
FIXTURES
SPECIFICATIONS
FOUNDATION
MATERIAL
EXTERIOR,
PIERS
Ft UES
MOTORS
WIDTH OF TOP
WIDTH OF BOTTOM
DEPTH IN GROUND
R.W. PLATE (SILL)
SIZE SPA„ SPAN
GIRDERS
JOIST 1st. FL.
JOIST 2nd. FL
JOIST CEILING
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 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
`JAL
f 1G1511
INAL
3N11 Altl3dOdd
A
PLOT PLAN
SETBACK
3NI1 )1H3dOHd
STREET
PLANNING & ZONING INFO.
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES(, I l- 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: