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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. USE A BALLPOINT PEN AND PRESS FIRMLY.
(OFFICE USE ONLY
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STREET ADDRESS:
CLASS AND SCOPE OF WORK:
SPECIFICATIONS:
BUILDING PERMIT NUMBER:
DATE OF APPLICATION:
LOT: BLOCK:
NEW
DEMOLITION
FOUNDATION
FOOTINGS
STEM WALL
PIERS
ZONING CSO P�IANCE:
DATE ISSUED:
TYPE
f/�(// /�`t
ALTERATION
REPAIR
SUBDIVISION / SURVEY:
ADDITION
MOVE
DIMENSIONS
VALUAT ON BASIS:
BUILDING PERMIT FEE:
DEPTH IN GRND
NAME:
USE OF BUILDING AUTHORIZED BY
REINFORCEMENT
VALUATION:
PLAN CHECK FEE:
THIS PERMIT:
BOLT SPACING
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MAILING ADDRESS:CRAWL
SPACE HEIGHT INCHES
OCCUPANCY
TOTAL FEE:
W
1 : /-• '0-.q 1rA. G "4
CRAWL SPACE VENT SQ. FEET
GROUP:
NCITY
& STATE:
SIZE HEIGHT
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A B E F H I M R S U
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NO. OF ROOMS STORIES
STRUCTURAL
SPECIES & GRADE
SIZE
SPACING
SPAN
RECEIPT NO:
TELEPHONE:
NO. OF FAMILIES
GIRDERS
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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
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MAILING ADDRESS:
SIZE OF LOT
JOISTS 2ND FLOOR
REQUESTED & COMPLETED
C
WATER: PUBLIC
PRIVATE
JOISTS 2ND FLOOR
TYPE OF CONSTRUCTION
PRIOR TO PROCEEDING WITH
H
CITY & STATE:
SEWER: PUBLIC
PRIVATE
CEILING JOISTS
ANY FURTHER WORK:
E
INSULATION TYPE & THICKNESS:
EXTERIOR WALLS
I II III IV V
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TELEPHONE:
BEARING WALLS
FOR INSPECTION CALL 486-8070
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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 ELECTRICAL
ON
MAILING ADDRESS:
FLOOR
WOOD HEATER YES NO
ROUGH PLUMBING
T
WALLS
ADEC APPLICATION:
FINAL
R
A
CITY & STATE:
ROOF
TYPE
SUBMITTED
DATE C.O. ISSUED:
C
I HEREBY ACKNOWLEDGE
FINAL APPROVAL
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TELEPHONE:
FINISH MATERIAL:
THAT I HAVE READ THIS APPLICATION,
THAT IT IS CORRECT AND THAT I AGREE TO COMPLY WITH ALL
ALASKA FIREMARSHAL REVIEW:
0
ROOF
ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION
SUBMITTED: APPROVED:
R
STATE LICENSE:
EXTERIOR SIDING
INTERIOR WALLS
APPLICANT:
APPROVED - BUILDING OFFICIAL: .-
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NOTES:
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PRINTED IN KODIAK, ALASKA SY PRINT MASTERS OF KODIAK