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LAKESIDE BK 2 LT 6 - ZCPZONING COMPLIANCY PERMIT Permit tt 6 z - Kodiak Island Borough, Community Development Department, 710 Mill Bay Road (Rm. 205), Kodiak, AK 99615 PH:(907)486-9362 Fax(907)486-9396 http://www.lcib.co.kodiak.ak.us APPLICANT PLEASE FILL IN THE INFORMATION BELOW: 1. Property Owner/Applicant: (21., 77. & V Mailing Address: P. /) h,ox 479, 5711-13‘,45 Phone: ..548:/—/A40 ;.2. Legal Description: 7Lc Street Address: I fig 5, / -TIC/ 3. Description of proposed action (attach site plan). Tax Code: R 7 Ma 6- 4. Site Layout: Actual Lot Area: /i15 ,10 • AL. Width: 4 Proposed Setbacks: Front: Side: 41',/z Rear zgy,, Building Height: 5. Use and size of existing structures on the lot: SFk t. 6. Number of parking space and size of parking area: STAFF WILL PROVIDE YOU WITH A COPY OF THE APPLICABLE CODE SECTIONS THAT APPLI S TO YOUR DEVELOPMENT ACTIVITY Zoning District 0 Parking Requirements 0 Solid Waste Removal Requirements EEI 1/6 ID INFORMATION FOR STAFF PURPOSES Compliance: Current Zoning: Use and size of existing structures on the lot: Minimum Requiied Lot Area:ErVidth:R" Setbacks: Front:R—Side:Ei—Rear: a Building Height:R-- Number & size �f parking spaces required per paikiii/site plan: 0 Off-streetloaditiveqUiretnents: 0 • Plat/subdivision related requirements (e.g. plat notes, easements, subdivision conditions, drainage plan review, etc.) Other Requirements (e.g. zero lot line, additional setbacks, projections into yards, screening, etc. Zoning Compliance Pe it Fee Paya ice Room # 104 Schedule: (per KIB Assembly Resolution Eff. July 1, 2005) Less than 1.75 acres 1.76 to 5.00 acres 1.00 5.01 to 40.00ficres 590.00 40.01 acres or more S120.00 Construction Dumpster Deposit PayabltC1ilrs.tffice Fee Schedule: (per MB Assembly Resolution Eff. July 1, 2005) Less than 250 sq. 251 to 500 sq. ft. . 0 501 or greater sq. ft. S1000.00 / 5 CMP Application Policies Res. ta."--- Bus. 0 Ind. 0 Other 0 Consistent with KIB CMP: Yes.felio0 Attachment: Yes0 No0 KODIAK ISLAND BOROUGH go.aO THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED **EXPIRATION: A zoning compliance permit will become null and void if the building or use'autho"rized by such permit is not commenced within 180 days from the date of issuance, or if the building construction or use is abandoned at any time, after the work is commenced, for a period of 180 days. Before such work can be recommenced, a new permit must first be obtained. (Sec. 106.4.4 Expiration, 1997 UBC) per KIBC 17.03.060. 1. Subd. Case #: Plat #: Bldg Permit #: 2. Driveway Permit (State, Borough, City) by/date: 3. Applicant Certification: I hereby certify that I will comply with the provisions of the Kodiak Island Borough Code and that I have the authority to certify this as the property owner, or as a representative of the property owner. I agree to have identifiable corner markers in place in the field for verification of setbacks. )( By: Date: y/a°%oos Title: Afillttiri v/ Supporting documents attached (check one): Site Plan: El As -Built Survey: t Other (List): 4. Com nity Dev ment Department By: R Title: Date: 915/4(- 5. Fire Marshal (UFC) by/date: • 6. Septic System Plan Approved by/date: This permit is ONLY for the proposed project as described by -the applicant. If there are any changes to the proposed project, including its intended use, prior to or durin its Sit n ' ' g ' g., .,construction; ,or::operaiion, contact this office' immediately to determine if further review and approval of the revised project is necessary. g 0 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; l'/ r it .5P ..C -'e?././ CLASS AND SCOPE OF WORK: SPECIFICATIONS: 1 BUILDING PERMIT NUMBER: DATE OF APPLICATION: f,1 .) LI VA) LOT: BLOCK: C• NEW DEMOLITION FOUNDATION FOOTINGS STEM WALL PIERS ZONING COMPLIANCE: ,., DATE ISSUED: Z_9 I:e.6 3Q' (-, - s - C G., ALTERATION - REPAIR TYPE r 7,71(7,/ s'; • - ;n1,Is..Z---U_- , /t J,r'j SUBDIVISION / SURVEY: Z;, j,ek%' ;/ 19 ADDITION 2/ MOVE DIMENSIONS >77x' -t-/ '-'/'f 6 'i VALUATION BASIS: BUILDING PERMIT FEE: i./ � , (. Si `1 `i ,, DEPTH IN GRND is _.' j N O W"� NCITY R NAME: /y (--):turfy, t!F/-al--c-71,,,--, > /i L (OfL¢Ydc'__/ USE OF BUILDING AUTHORIZED BY THIS PERMIT: REINFORCEMENT . ,7y'�( ?. =r ) } 4) ;� /J' VALUATION: �� __� PLAN CHECK FEE: ;`), t� -` / LA — BOLT SPACING ' t ' MAILING ADDRESS: f f"� ! /951 _s/J tGROUP: CRAWL SPACE HEIGHT -? r r e -� h ;� , ;' INCHES OCCUPANCY TOTAL FEE: ( CRAWL SPACE VENT c,..79176/ S.Q`. FEET A B E H 1 M ;' �' && STA/TE: p/�'f 11 i i ) % Jit f r SIZE -; //AN HEIGHT ' STRUCTURAL SPECIES & t/ SIZE /SPACING SPAN NO. OF ROOMS r� STORIES / ,'`- ' '' RECEIPT NO: TELEPHONE: . y 5/0 NO. OF FAMILIES 1 GIRDERS - , /VC) /7 I ff DIV. 1 :, 2 3 j 4 5 6 ':":9 EACH OF THE FOLLOWING STAGES OF CONSTRUCTION REQUIRES INSPECTION BE REQUESTED & COMPLETED TYPE OF BUSINESS GIRDERS A R C HCITY E N G NAME: NO. OF BLDGS NOW ON LOTS._ JOISTS 1ST FLOOR- Yf/,;j f' /,/. „ ;?k /17 (9CJ{'_, !S' ;1> USE OF EXISTING BLDGS /Pp..; /4, JOISTS 1ST FLOOR/ MAILING ADDRESS: SIZE OF LOT JOISTS 2ND FLOOR ') WATER: PUBLIC . PRIVATE JOISTS 2ND FLOOR - i .f TYPE OF CONSTRUCTION PRIOR TO PROCEEDING WITH I II III IV V - 13 1 FR H.T. ANY FURTHER WORK: FOR INSPECTION CALL 486-8070 & STATE: SEWER: PUBLIC 1,,, PRIVATE CEILING JOISTS /1'7 ill-. //k. :=2 id 11->�5r K INSULATION TYPE & THICKNESS: EXTERIOR WALLS." //f,1,'" f/Z, ...7V.--, `� ,-)19 ,,--.1j- TELEPHONE: ,// FOUNDATION /71-,.--.7/e",4/,,,-,-/ • BEARING WALLS — / INTERIOR WALLS I -HR I EXCAVATION STATE LICENSE: WALLS :f"- `/ ROOF RAFTERS UNDERGROUND UTILITIES ROOF / CEILING j2-5'6-) TRUSSES _.44- 4/9 -'7.-if. DRIVEWAY PERMIT: FOUNDATION / SETBACKS UOZHOC<o12,bcr 1 NAME: J 6 1i,:e iry, F75 SHEATHING TYPE & SIZE:� FURNACE TYPE: f f 4 ;,. .F'/�o, J /4 SUBMITTED FRAMING " , ,.J FLOOR %-1r ,I J(', ;,1.%'!4?, f,i,y�;;Wir APPROVED ROUGH ELECTRICAL MAILING ADDRESS: _ 70 WOOD HEATER YES ;,`'NO /1 -' TYPE ROUGH PLUMBING WALLS./-' '" - ADEC APPLICATION: FINAL SUBMITTED DATE C.O. ISSUED: CITY & STATE: //lr(2,ii/:i - /r•. ROOF_- t /`-;f--4 /- -- ,- % ° ' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT IT IS CORRECT AND THAT I AGREE TO COMPLY WITH ALL ORDINANCES AND L S REGULATING BUILDING CONSTRUCTION ! .f ft APPLICANT: !'�I f'i' '�, f �✓'0,-., ,, FINAL APPROVAL TELEPHONE: 42 ' .� f Z" ,,i�G . ��� r' FINISH MATERIAL: '<';1. ,,; ;� +, ALASKA FIREMARSHAL REVIEW: SUBMITTED: APPROVED: , -' t. '' '` ROOF t11� n' ` ,� t ; ; r r.,1• s , i � STATE LICENSE: 3� r� / EXTERIOR SIDING J-41,1'� • '‘i,,/ t" %'•-' ` i57 , �:t -f, APPROVED - BUILDING OFFICIAL: ;` INTERIOR WALLS ,�`) y 1:-/ /r`. ,!, t' NOTES: % _ .� �? ',2-7.-,(...e • i i • ,/ L;2 /fid ! SYSTEM DEVELOPMENT FEE 1 r ✓ WATER $ DATE SEWER $ RECEIPT # •., TOTAL $ CASHIER ev. PRINTED IN KODIAK, ALASKA BY C&A PRINTING, INC. KODIAK ISLAND BOROUGH Community Development 710 Mill Bay Road (Rm 205), Kodiak, Alaska 99615-6340 - Phone: (907) 486-9362 Z O N I N G COMPLIANCE FEE: $20.00 PERMIT Permit #: / Z- /4 — (it 3 q 1 3. Property Owner/Applicant: ___. / 2 Y 61 I / / Number and size of parking spaces/required (onsite identification of parking spaces is required - Yes: No: ) Mailing Address: /967 se// o f Phone: z 4% /6 / Vk Ck4 e Legal Description: 6 //2J VI c� Off-street loading requirement: 44 /x/1-2 Street Address: /9�I o.XL.(�l Tax�Code #: � 7(/(Q/. 1LkO `Or (JD Q Plat related requirements (e.g., plat notes, easements, subdivision conditions, etc.): Description of Pro eli /CurrentZonin : P Existing P Y g 1� \ �V�. Minimum Required Lot Area: ! -Q� S Width: (00 Other requirements-(e.g., zero lot line, additional setbacks, projections into yards, screening, etc.): t Actual Lot Area: 1 t 1LAL\S S Tt. Width: 40\ MiI`1 Minimum Required Setbacks: Sides: 5 I Front: CDS- t Rear: I O Coastal Management Program Applicable Polices (check appropriate category) - Residential: j(- Business: Maximum Building Height: *5 Industrial: Other (list): I Use and size of existing structures on the lot: Sr -7 7'C Ga Is the proposed action consistent with the KIB Coastal Management Program? - Yes: No: A- . If the proposed action conflicts with the Coastal Management Program policies, attach a sheet that notes the policy(ies), describes the conflict(s), and specifies conditions to mitigate the conflict(s). Attachment - Yes: ,A7 No: Description of proposed action (attach site plan): fJ%(XO* Z /` e. - ( // lig co THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED Expiration: A zoning compliance permit will become null and void if the building or use authorized by such permit is not commenced with 180 days from the date of issuance, or, if the building construction or use is abandoned at any time, after the work is commenced. fora period of 180 days. Before such work can be recommenced, a new permit shall be first obtained to do so. (Sec. 303 (d) Expiration, 1991 Uniform Building Code) per KIBC 17.03.060 Applicant Certification: I hereby certify that I will rompl% with the• provisions of the Kodiak bland Borough ('ode and that I have the authority to certify this as the property owner. or aa repres(r t, 've of the proper tJ vner. I agree to have identifiable corner markers in place in the field fur errfie'ation of setbacks. By: Supporting documents attached (cheek): Site plan: Title:i,—.7 As -built survey 6. Community Development staff for zoning, by: Date: 9,14 Other (list Title.: 444.4/1.4/ Date. V/ /7/ 0000030 000015212 6/17150 14:08:37 bob P R 1 D 20.00 ZCP FREE F0f04 LINE 11.1 np u� 03 44 7. Fire Chief [City of Kodiak, Fire District #1 (Bayside), Womens Bay Fire District] approval for UFC (Sections 10.207 and 10.301C) by: Date: 8. Driveway Permit (state, City of Kodiak, Borough) issued by: Dale 9. Septic system PLAN approved by: Date: D..tri h ul lOn Fila rorie rnali ' Building (o((u eat / Applicani / Asr..r ng lulu 1. 19,1.7 44' APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANY - CITY OF KODIAK — KODIAK ISLAND BOROUGH — BUILDING DEPARTMENT (APPLICANT TO FI Telephone: 486-3224 700 Mill Bay Road IN ALL INFORMATION WITHIN BOLD LINES. PLEASE PRINT. USE A BALLPOINT PEN AND PRESS FIRMLY.) (OFFICE USE ONLY), STREE9ET AADDRESS , CLASS%%AND S OPE OF WOR SPECIFICATIONS: BUILDING PERMIT NUMBER: DATE OF APPLICATION: LOT `: ••` BLOCK f..;• NEW DEMOLITION FOUNDATION FOOTINGS TEMWALL PIERS ZONING COMPLIANCE DATE ISSUED: ,r� � !� t /f C° ] 11 ' r%i%�3 1SUBDIVISION ALTERATION REPAIR TYPE `r//:f'i'll srt' i"�1 /SURVEY: ,'`J I .),I `` ` -.moi l i. tDEPTH ADDITION MOVE - DIMENSIONS{j { ? / /') VALUATION BASIS: BUILDING PERMIT FEE: f dNAME tN GRND • j f E -l�€ /•1{PERMIT:BOLT USE OF BUILDING AUTHORIZED BY THIS '� r C. C f % L� REINFORCEMENTVALUATION :::::;;;:',1i7,:aeS r PLAN CHECK FEE: S } (� ! 4J .J`Y a t+a/- SPACING ' 1` (= MAILI/NG A KESS: �/�) If/)� % t S / d /1 t / ll • '2 � ..>,i/ / _ 71)6 CRAWL SPACE HEI ,. INCHES OCCUPANCY GROUP: TOTAL F E 'I , ,+'" �.r. / 2 ! 4� . l r CRAWL SPACE VENT ,/,',/,)--';.-- ,`x3sv! 1 ae.13/ SO. FEET A 8 E H 1 M R/ RECEIPT NO,: ' t'; � •,�? % R CITY &STATE: r �, %�?{ , ;"6'' r� ' / / tr cp/tL SIZE �l - HEIGHT STRUCTURAL " SPECIES & GRADE SIZE SPACING SPAN �r 1 2 t3) 4 5 6 EACH OF, THE FOLLOWING STAGES OF • CONSTRUCTION REQUIRES INSPECTION NO, OF ROOMS ;/ STORIES / TELEPHONE ..•:rDIV. h, � t NO. FAMILIES / GIRDERS TYPE OF BUSINESS 7'/t' GIRDERS '` r A NAME: NO. OF BLDGS NOW ON LOT / JOISTS 1ST FLOOR 1 iBE USE OF EXISTING BLDGS:.''''"12V(_, X4;4 ' /'., JOISTS 1ST FLOOR C_,) .,, , TYPE OF CONSTRUCTION I II 111 IVV REQUESTED & COMPLETED PRIOR TO PROCEEDING WITH ANY FURTHER WORK: FOR INSPECTION CALL 486-3224 R C MAILING ADDRESS: SIZE OF LOT JOISTS 2ND FLOOR f; / WATER: PUBLIC , PRIVATE JOISTS 2ND FLOOR f H / CITY & STATE: SEWER: PUBLIC �' PRIVATE _ CEILING JOISTS r.J INSULATION TYPE & THICKNESS: EXTERIOR WALLS L.,/ j 1 -HR FR H.T. EXCAVATION . BEARING WALLS f { G TELEPHONE : FOUNDATION UNDERGROUND UTILITIESN INTERIOR WALLS ^- DRIVEWAY PERMIT: FOUNDATION /SETBACKS STATE LICENSE : WALLS ROOF RAFTERS SUBMITTED FRAMING ' ROOF / CEILING TRUSSES APPROVED ROUGH ELECTRICAL lie NAME: te'99/ ,,�A.J' _: SHEATHING TYPE & SIZE: FURNACE TYPE: ROUGH PLUMBING FLOOR ADEC APPLICATION: FINAL SUBMITTED DATE C.O. ISSUED: WOOD HEATER YES NO _ TYPE T MAILING ADDRESS: ; FINAL APPROVAL WALLS R A CITY & STATE: ROOF ALASKA FIREMARSHALL REVIEW: SUBMITTED: APPROVED:, I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION THAT IT IS. CORRECT AND THAT I AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS, REGULATING BU LDING CONSTRUCTION y41-17 - .r, APPLICANT: a,., l ,tw - , .!.i., C T TELEPHONE : FINISH MATERIAL: ROOF , / " , APPROVED --,-BUILDING OFFICALS- 0 R STATE LICENSE : EXTERIOR SIDING INTERIOR WALLS NOTES: r 7 I Kodiak Island Borough Community Development Department ZONING COMPLIANCE PERMIT 1. Property Owner/Applicant Zoning Compliance #: Name: q /� (� �(� Mailing address: I Z �trCt C412_4_, tom(, Telephone # L/C--LIS-f0 2. Zoning Requirements for New Construction - Description of Proposed Action (attach site plan) CcM,S lLLy"-�G�T7=r. c5�14G(ti 64Cc e-S$cj ®4 S et c c am . S Ia2- e s..s kv.0 c-(- c.�.� — Sem 134 -Liz iz �z • 1 / c -ev c lei' aoucJt� Use of proposed structure(s)• 3. Legal Description of Property / / /G��S / Street address. � eJ l `_ 4.,RA"-(-y Road access for emergency vehicles: Yes No Date (contact Fire Chief for confirmation) _Water supply adequate for public use, institutional use, commercial, and residential n , M Fuctures larger than a triplex: Yes No Date /vH' ontact Fire Chief for confirmation) Lot area: 1/, LI 5 ,121 Minimum setbacks - Front: 02.5 - Lot width* Rear: / /0 Sides - Left: S Right c- Maximum building height S 5 / IXc-U Q,U�LI.�( 1 L SGcea l�YwacI s.•v `� p� Maximum lot coverage. Number and size of parking spaces required* Off-street loading requirement Plat related requirements' / X� Ai— Sr )2. A) A" Other (e.g. zero lot line, additional setbacks, projections into yards, screening, etc.): 7. Borough Staff A r val Signed: Lot, Block, Subdivision. L5 t ) 6`4..• 2—, t--,vKrei-5i-ds-, 'S-4 G Survey, other (e.g. Township/Range) Tax Code #: R74I S9 02-enfn0 Description of Existing Property Zoning: I — 5F ip . Minimum Area: 7,290 j Minimum Lot Width* Use and size of existing buildings on the lot* Vete-- 5. Consistency with Coastal Management Program Applicable policies - Residential: Other Proposed action consistent with Borough Coastal Management Program - Yes: No. If proposed action conflicts with Coastal Management Program policies, attach a sheet that notes the policy(ies), describes the conflict(s), and notes the condition(s) attached to the consistency approval to mitigate these conflicts. Attachment - Yes No Business: Industrial. 6. Applicant Certification I hereby certify that I will comply with all provisions of the Kodiak Island Borough Code and that I have the authority to certify this as owner, or representative of the owner, of the property involved. I agree to have corner markers in place for verification of setbacks. Signed. Owner: I Date Support Documents Attached - Site Plan* As Built Survey: Other Title: �� S�yi Date* eiT/Z6-r" THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED Distribution: White to File Yellow to Building Official - Pink to Applicant Kodiak Island Borough Community Development Department 710 Mill Bay Road (Room 204), Kodiak, Alaska 99615-6340. Phone (907) 486-5736, extension 255. July 1, 1988 . •10390 S.F. i60.2S N 44'55.43!N •LOT -7 •ii445 B.F. N 44'58'4 %.ILOT-4 12222 S.F. N 44'58''4341 •I.OT-i •i2740 S.F. N 44.513'43"W White copy: File Yellow copy: Building Permit Pink copy: Applicant ZONING COMPLIANCE PERMIT 1. PROPERTY OWNER/APPLICANT Name: Address: 0'713/ 41. 2. LEGAL DESCRIPTION Ty 0 C-411-4— FrA-OPER Ko 'Island Borough Corimiunity Development Department 710 Mill Bay Road, Room 204 Kodiak, Alaska 99615 (907)486-5736 Ext. 255 Zoning Compliance #: - Telephone: 0 Street Address: / q is- y c ' Average lot depth: Average lot width: Lot depth to width ratio: 4-re,it-v-, -a. ‘ ...L.6,,,,L....„L 9c-4. Minimum Setbacks—Front: ,..,t,<- r- Lot, block, subdivision: CAI.,.....* 6 ig t 4..._ I 2_—_ -- ' L-54....L5A tt—e- ..,-;,---4 I Survey, other (e.g. township/range): Maximum building height: < Maximum lot coverage: / C:76/0 /-e-...c R/L( Number and size of parking spaces required: Tax code #: le - 7 c( 7-4- 0 2_ 0 D co 0 Off-street loading requirement: Plat related requirement(s): 3. DESCRIPTION OF EXISTING PROPERTY Zoning: L4 g / Square footage of lot: (J 7 0 q P Minimum lot width: Average lot depth: Average lot width: Lot depth to width ratio: 4-re,it-v-, -a. ‘ ...L.6,,,,L....„L 9c-4. Minimum Setbacks—Front: ,..,t,<- r- Use and size of existing buildings on the lot: till 0L--c—ri--,sf Sides: S 4. DESCRIPTION DESCRIPTION OF PROPOSED ACTION (attach site plan) C.) 5. ZONING REQUIREMENTS FOR NEW CONSTRUCTION yroFtif structure(s): a) "T,i sr CA-,...s4\-NA-c-A:tr, rvIctio-i flet..,(1.. 4- 1—o -t) ( () A -cc_ fll i 1Z, „d.— 4-re,it-v-, -a. ‘ ...L.6,,,,L....„L 9c-4. Minimum Setbacks—Front: ,..,t,<- r- ( Rear: / 0 Sides: S Additional Setbacks: . Maximum projection(s) into required yards: Proposed action conflicts with policies (note policy and describe conflict): Maximum building height: < Maximum lot coverage: / C:76/0 /-e-...c R/L( Number and size of parking spaces required: t e ,.... S- ")4 .P.. d Off-street loading requirement: Plat related requirement(s): Other (e.g. zero lot line): a - V,... . . . 6. CONSISTENCY WITH COASTAL MANAGEMENT PROGRAM Applicable policies: -)--S f t "9-'kti"" ;0‘.1 Proposed action consistent with Borough Coastal Management Program Y s No Proposed action conflicts with policies (note policy and describe conflict): AA--{ Conditions attached to Consistency approval to mitigate conflicts noted above: lc.) 7. APPLICANT CERTIFICATION I hearby certify that I will comply with all provisions of the Kodiak Island Borough Code and that I have the authority to certify thi as owner, or representative of the owner, of the property(s) involved. 8. SUPPORT DOCUMENTS ATTACHED ) Site Plan: 0 Other: 9. BOROUGH STAFF APPROVAL Staff Approval: Signed Title Date Building permit #: BUILDING 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. STREET ADDRESS ALTERATION REPAIR BUILDING PERMIT NUMBER NEAREST CROSS STREET ADDITION MOVE USE OF BUILDING SIZE OF BUILDING HGT NO. OF ROOMS / FLOORS NO. OF FAMILIES �• VALUATION: (BASIS) NAME ,-,,/ W MAILING ADDRESS z O CITY, STATE TELEPHONE ',1,4 NO. OF BUILDINGS NOW ON LOT w W w - S 0 Z Qw CONTRACTOR NAME ADDRESS CITY, STATE STATE LICENSE NO. NAME ADDRESS CITY, STATE STATE LICEASE NO. (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 1 V V FR 1 -HR. N H.T. USE OF BUILDINGS SIZE OF LOT AMOUNT WATER: PUBLIC PRIVATE SEWER: PUBLIC PRIVATE SPECIFICATIONS FOUNDATION TYPE DEPTH IN GND HGT FIN GRADE EXT PIERS BUILDING DATE ISSUED BLDG PERMIT FEE PLAN CHK FEE TOTAL INSPECTION SCHEDULE FOUNDATION FRAME PLASTER/BD FLUES PLUMBING ROUGH SEPTIC TANK SEWER P.T. PLATE (SILL) STRUCTURAL SIZE SPA. SPAN GIRDERS JOISTS 1ST FLR. FINAL GAS FINISH ELECTRICAL ROUGH FINISH FIXTURES MOTORS FINAL 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 BY 20 -FOOT CULVERT IS REQUIRED AT EACH DRIVEWAY ACCESS TO THE PROPERTY. JOISTS 2ND FLR. JOISTS CLG EXT STUDS INT STUDS SANITATION PLAN APPROVAL. BV 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. INSTALLER'S PLAN APPROVAL RECEIVED NSTALLER ROOF RAFTERS TRUSSES BEARING WALLS INSULATION, FNDN IWALLS 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 15 CORRECT, AND THAT 1 AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION. APPLICANT PRIOR TO THE ISSUANCE OF A PERMIT, EITHER THE OWNER OF THE 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: PER CLOSING DATE, DEED RECORDED (BY) APPROVED, BUILDING OFFICIAL • PLOT PLAN (A SITE PLAN MAY ALSO BE REQUIRED) REAR PROPERTY LINE -� Log FRONT PROPERTY LINE SIDE PROPERTY LINE STREET NOTE: APPLICANT SHALL SHOW BUILDING SETBACKS FROM PROPERTY LINES, AS PERPENDICULAR DISTANCES FROM PROPERTY LINES TO BUILDING. DIMENSIONS OF STRUCTURE SHALL BE SHOWN ON THE PLAN. ZONING CODE COMPLIANCE ZONING DISTRICT TYPE OF OCCUPANCY NO. OF STORIES TOTAL HGT AREA OF LOT SETBACKS FROM PROPERTY LINES: FRONT REAR SIDE (L) SIDE (R) REQ'D OFF-STREET PARKING C.U.P. OR VARIANCE APPROVED, ZONING OFFICER