KODIAK TWNST BK 16 LT 4B - Building PermitRI' L/o//1 L,Dy
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APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY - CITY OF KODIAK - KODIAK ISLAND BOROUGH - BUILDING DEPARTMENT
Telephone: 486-8070 • 486-8072 Fax: 486-8600 710 Mill Bay Road, Room 208
(APPLICANT TO FILL IN ALL INFORMATION WITHIN BOLD LINES. PLEASE PRINT
PRINTED IN KODIAK, ALASKA BY PRIt T MASTERS OF KODIAK
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:
-3 ` i
ALTERATION
REPAIR
TYPE
a
i t
SUBDIVISION / SURVEY:
ADDITION
MOVE
DIMENSIONS
VALUATION BASIS:
.i
BUILDING PERMIT FEE:
1.1
DEPTH IN GRND
O
++
l a "
NAME:
USE OF BUILDING AUTHORIZED BY
REINFORCEMENT
VALUATION:
i-2
PLAN CHECK FEE:
THIS PERMIT:
BOLT SPACING
MAILING ADDRESS:
O
CRAWL SPACE HEIGHT INCHES
OCCUPANCY
TOTAL FEE:
W
CRAWL SPACE VENT SQ. FEET
GROUP:
N
E
CITY & STATE:
SIZE HEIGHT
R
NO. OF ROOMS • STORIES
STRUCTURAL
SIZE
SPACING
A B E F H I M 'f S U
(.>,
SPECIES & GRADE
SPAN
TELEPHONE:
NO. OF FAMILIES
GIRDERS
RECEIPT NO:
TYPE OF BUSINESS
GIRDERS
EACH OF THE FOLLOWING
NAME:
NO. OF BLDGS NOW ON LOT +
JOISTS 1ST FLOOR
DIV. 1 2 ,� 4 5 6
STAGES OF CONSTRUCTION
A
USE OF EXISTING BLDGS
JOISTS 1ST FLOOR
REQUIRES INSPECTION BE
R
MAILING ADDRESS:
SIZE OF LOT
JOISTS 2ND FLOOR
REQUESTED & COMPLETED
C
H
WATER: PUBLIC
I
PRIVATE
I {
2ND
OIIL
TYPE OF CONSTRUCTION
PRIOR TO PROCEEDING WITH
/
CITY & STATE:
SEWER: PUBLIC
.
PRIVATE
NG JOISTSFLOORSTS
FURTHER WORK:
INSULATION TYPE &THICKNESS:
EXTERIOR WALLS
1 11 III IV VEANY
N
TELEPHONE:
BEARING WALLS
FOR INSPECTION CALL 486-8070
G
FOUNDATION
INTERIOR WALLS
N 1 -HR FR H.T.
EXCAVATION
STATE LICENSE:
WALLS
ROOF RAFTERS
UNDERGROUND UTILITIES
ROOF / CEILING
TRUSSES
DRIVEWAY PERMIT:
FOUNDATION / SETBACKS
NAME:
SHEATHING TYPE & SIZE:
SUBMITTED
FRAMING
C
FURNACE TYPE:
APPROVED
ROUGH
N
MAILING ADDRESS:
FLOOR
WOOD HEATER YES NO
ELECTRICAL
ROUGH PLUMBING
T
WALLS
ADEC APPLICATION:
FINAL
R
CITY & STATE:
A
ROOF
TYPE
SUBMITTED
DATE C.O. ISSUED:
C
I HEREBY
FINAL APPROVAL
TELEPHONE:
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION,
T
FINISH MATERIAL:
THAT IT IS CORRECT AND THAT I AGREE TO COMPLY WITH ALL
ALASKA FIREMARSHAL REVIEW: ;c�2627282
0
ROOF
ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION
SUBMITTED: APPROV D 9ti
R
STATE
LICENSE:
EXTERIOR SIDING
R►
INTERIOR WALLS
APPLICANT:
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APPROVED
- BUILDING OFFICIAL:. �
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NOTES:
Rev. 1-97
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PRINTED IN KODIAK, ALASKA BY PRIt T MASTERS OF KODIAK
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