KODIAK TWNST BK 13 LT 3 - Building PermitW._ 1-34 F.
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. 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:
TYPE
ALTERATION
REPAIR
SUBDIVISION /�SxRtVgj`.5ti— '
ADDITION
MOVE
DIMENSIONS
VALUATION BASIS:
BUILDING PERMIT FEE:
DEPTH IN GRND
IL1,1)141 . —"`
NAME:
USE OF BUILDING AUTHORIZED BY
•
REINFORCEMENT
VALUATION:
PLAN CHECK FEE:
THIS PERMIT:
BOLT SPACING
0
MAILING ADDRESS:
CRAWL SPACE HEIGHT INCHES
OCCUPANCY
TOTAL FEE:
W
CRAWL SPACE VENT SQ. FEET
GROUP:
NCITY
& STATE:
SIZE HEIGHT
A B E F H I M R S U
R
4'd'(pfi4-- /1' -
NO. OF ROOMS STORIES
STRUCTURAL
SPECIES & GRADE
SIZE
SPACING
SPAN
RECEIPT NO:
TELEPHONE:
NO. OF FAMILIES
GIRDERS
( ') 2 [" 1
TYPE OF BUSINESS
GIRDERS
EACH OF THE FOLLOWING
NAME:
NO. OF BLDGS NOW ON LOT
JOISTS 1ST FLOOR
DIV. 1 2 3 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
WATER: PUBLIC'
PRIVATE
r
I
JOISTS 2ND FLOOR
TYPE OF CONSTRUCTION
PRIOR TO PROCEEDING WITH
HCITY
& STATE:
SEWER: PUBLIC
I PRIVATE
I
CEILING JOISTS
ANY FURTHER WORK:
E
INSULATION TYPE & THICKNESS:
EXTERIOR WALLS
I 11 III IV V
N
TELEPHONE:
BEARING WALLS
N 1 -HR FR H.T.
FOR INSPECTION CALL486-8070
G
FOUNDATION
INTERIOR WALLS
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 ELECTRICAL
NMAILING
ADDRESS:
FLOOR
WOOD HEATER YES NO
ROUGH PLUMBING
T
WALLS
ADEC APPLICATION:
FINAL
R
CITY & STATE:
ROOF
TYPE
SUBMITTED
DATE C.O. ISSUED:
A
C
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION,
FINAL APPROVAL
T
TELEPHONE:
FINISH MATERIAL:
THAT IT IS CORRECT AND THAT 1 AGREE TO COMPLY WITH ALL
ALASKA FIREMARSHAL REVIEW:
0
ROOF
ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION
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SUBMITTED: A'P' •` •ED:
R
STATE LICENSE:
EXTERIOR SIDING
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INTERIOR WALLS
APPLICANT:
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APPROVED -BUILDING OFFICIAL:. ,�f)
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NOTES: (A)°J Frna (`G�hied rvA
r e Department
LO
t ritY of Kodiak vti 1
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Rev 1-97
PRINTED IN KODIAK, ALASKA BY C&A PRINTING, INC.
CITY TEL. NO.
MAIL ADDRESS
NAME
BUILDING DEPARTMENT — CITY / BOROUGH OF KODIAK
Applicant to fill in between heavy lines.
CLASS OF WORK
BUILDING ADDRESS
NEAREST CROSS ST.
w
Z
0
NAME
1
w
J
DESCRIPTION
ADDRESS
CITY
STATE LICENSE NO.
NAME
NEW
DEMOLISH
ALTERATION
REPAIR
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,
PIERS
ADDRESS
CITY
STATE LICENSE NO.
SUBDIVISION
LOT NO. BLK.
5
WIDTH OF TOP
WIDTH OF BOTTOM
DEPTH IN GROUND
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE
OF OCCUPANCY
BUILDING PERMIT NO.
VALUATION
BUILDING
FOUNDATION
FRAME
PLASTER
FLUES
R.W. PLATE (SILL)
SPA..
SPAN
GIRDERS
JOIST 1st. FL.
JOIST 2nd. FL
JOIST CEILING
DO NOT WRITE BELOW THIS LINE
EXTERIOR STUDS
INTERIOR STUDS
ROOF RAFTERS
0. Type of Construction
1, 11, 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
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
FINAL
DATE ISSUED
BLDG. FEE
PLAN CHK. FEE
TOTAL
PLUMBING
ROUGH
SEPTIC TANK
SEWER
GAS
FINISH
1/6 V4 '/4%/(C
�g/lZ3
C"'BSc
ELECTRIC
ROUGH
FINISH
FIXTURES
MOTORS
FINAL
3N1-1 Alei3c102zicl
A
PLOT PLAN
SETBACK
3N11 J.12f3dO21d
STREET
-
PLANNING & ZONING INFO.
ZONING DISTRICT
TYPE OF OCCUPANCY
NUMBER OF STORIES TOTAL HT.
AREA OF LOT
FRONT YARD SETBACK FROM PROP. LINL
SIDE YARD SETBACK FROM PROP. LINE
REAR YARD
Approved: CHIEF BUILDING OFFICAL Approved: ZONING ADMINISTRATOR
By: By•