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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)
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
; / /f ,,/72 -,
ALTERATION
REPAIR
SUBDIVISION / SURVEY:
ADDITION
MOVE
DIMENSIONS
VALUATION BASIS:
BUILDING PERMIT FEE:
DEPTH IN GRND
NAME:
USE OF BUILDING AUTHORIZED BY
REINFORCEMENT
VALUATION:
PLAN CHECK FEE:
�/
}'f !o, ? .ttR . 4 f }d
THIS PERMIT:
BOLT SPACING
0
MAILING ADDRESS: /
CRAWL SPACE HEIGHT INCHES
OCCUPANCY
TOTAL FEE:
W
i i. A ;. r
CRAWL SPACE VENT SQ. FEET
GROUP:
N
CITY & STATE:
i
SIZE HEIGHT
ABEFHIMRSU
R
NO. OF ROOMS STORIES
STRUCTURAL
SPECIES & GRADE
SIZE
SPACING
SPAN
RECEIPT NO:
TELEPHONE:
NO. OF FAMILIES
GIRDERS
`/; 1' /tom. (, A. 7
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
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 11 III IV V
N
BEARING WALLS
N
FOR INSPECTION CALL 486-8070
G
FOUNDATION
INTERIOR WALLS
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
O
N
MAILING 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
FINAL APPROVAL
T
TELEPHONE:
FINISH MATERIAL:
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 �.
NOTES:
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PRINTED IN KODIAK, ALASKA, BY PRI,.
Keine,
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY - CITY OF KODIAK - KODIAK ISLAND BOROUGH - BUILDING DEPARTMENT
Telephone: 486-8070 710 Mill Bay Road
(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: (3k.
4 r/
NEW
DEMOLITION
FOUNDATION
FOOTINGS
STEM WALL
PIERS
ZONING COMPLIANCE:
DATE ISSUED:
j j r,
r �'
t
ALTERATION
REPAIR
TYPE
---
1
SUBDIVISION / SURVEY: KO
`---=—T_7a.)15a
ADDITION
MOVE
DIMENSIONS
VALUATION BASIS:
BUILDING PERMIT FEE:
'--' '
DEPTH IN GRND
O
W
NCITY
R
NAME:USE
= =y"
OF BUILDING AUTHORIZED BY
THIS PERMIT:
REINFORCEMENT
VALUATION: ,r- -
PLAN CHECK FEE:
C'
_
BOLT SPACING
CRAWL SPACE HEIGHT INCHES
OCCUPANCY GROUP:
TOTAL FEE:
MAILING ADDRESS:
`
AB E H I M
( ,f
CRAWL SPACE VENT SQ. FEET
& STATE:
SIZE HEIGHT
STRUCTURAL
SPECIES & GRADE
SIZE
SPACING
SPAN
NO. OF ROOMS STORIES
RECEIPT NO:
TELEPHONE:
NO. OF FAMILIES
GIRDERS
DIV. 1 2 �3 4 5 6
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 LOT
JOISTS 1ST FLOOR
USE OF EXISTING BLDGS
JOISTS 1ST FLOOR
MAILING ADDRESS:
SIZE OF LOT
JOISTS 2ND FLOOR
WATER: PUBLIC
PRIVATE
JOISTS 2ND FLOOR
TYPE OF CONSTRUCTION
PRIOR TO PROCEEDING WITH
I II III IV V
N 1 -HR FR H.T.
ANY FURTHER WORK:
FOR INSPECTION CALL 486-8070
& STATE:
SEWER: PUBLIC
PRIVATE
CEILING JOISTS
INSULATION TYPE & THICKNESS:
EXTERIOR WALLS
TELEPHONE:
FOUNDATION
BEARING WALLS
INTERIOR WALLS
EXCAVATIO c, 7--
STATE LICENSE:
WALLS
ROOF RAFTERS
i -t F '
-
-N-----=
.UNDERG#v1mD UT�I�,�
ROOF / CEILING
TRUSSES
DRIVEWAY PERMIT:
FOUN4 ATION / St BACKS/
SUBMITTED
FRAMI;NG
0 0 Z H CC< 0 F 0 CC
NAME:
SHEATHING TYPE & SIZE:
FURNACE TYPE:
FLOOR
APPROVED
rr''''��
ROU¢�H ELECT -Ma
WOOD HEATER YES NO
TYPE
ROJH PLUMBd
MAILING ADDRESS:
WALLS
ADECAPPLICATION:
FINAL FinanceD"aartlrent
SUBMITTED
c'iDtf i
DATIcG,O. ISS(e.l;��
D
CITY & STATE:
ROOF
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
FINAL APPROVAL
TELEPHONE:
FINISH MATERIAL:*
ALASKA FIREMARSHAL REVIEW:
SUBMITTED: APPRO, ED:
ROOF
STATE LICENSE:
EXTERIOR SIDING
APPROVED - BUILDING OFFICIAL: - ,
v,
/
_
APPLICANT: f" '
INTERIOR WALLS
NOTES:
L SYSTEM DEVELOPMENT FEE
WATER $ DATE
SEWER $ RECEIPT #
TOTAL $ CASHIER
Printed In Kodiak, Alaska by C & A Printing Inc.