HOSPITAL BK 1 LT 2A-1 - ZCP 2/1/2019Y� Kodiak Island Borough Print Form Submit by Email
Community Development Department
Ik-9 710 Kodiak AK 99615 205
Mill Bay Rd. 5IIIIIIIIIIIIIIIIIIIIIIIII
Ph. (907) 486 - 9363 Fax (907) 486 - 9396
23656
http://www.kodiakak.us
Zoning Compliance Permit Permit No. CZ2019-037
The following information is to be supplied by the Applicant:
Property Owner /Applicant: KIB/Providence/Architects AK
Mailing Address: 710 Mill Bay Road
Phone Number: 907-486-9304
Other Contact email, etc.:
Legal Description: Subdv: HOSPITAL BK 1 LT 2A-1 Block: Lot:
Street Address: 1915 Rezanof
Use & Size of Existing Structures: Hospital
Description of Proposed Action: Convert two patient rooms into respiratory therapy room.
Site Plan to include: Lot boundaries and existing easements, existing buildings, proposed location of new construction, access points,
and vehicular parking areas.
Staff Compliance Review:
Lot Area: 11.82 Acres
Front Yard: 24'
Prk'g Plan Rvw? Not Applicable
Staff Compliance Review Notes:
Plat / Subdivision Requirements?
Current Zoning: Public Use
Lot Width:
KIBC 17.130
Rear Yard: 25%/25'
# of Req'd Spaces:
No change to gross floor area.
Bld'g Height:
Side Yard:
PROP_ID 23656
10%/25'
Subd Case No. Plat No: Bld'g Permit No. TBD Bldg Dept
Does the project involve YES
an EPA defined facility?
*Commercial buildings, installations (military bases),
institutions (schools, hospitals) and residences with
more than four (4) dwelling units.
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
N/A
N/A
TBD Bldg Dept
Proof of EPA notification provided (if required)? NO
*Required for all demolitions, for renovations disturbing at least 160 square
feet, 260 linear feet, or 35 cubic feet of Regulated Asbestos Containing Material (RACM), and
for renovations that remove a load -supporting structural member.
No permit will be issued for such projects without proof of EPA notification
Applicant Certification: 1 hereby certify that 1 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. 1 agree to have identifiable
corner markers in place for verification of building setback (yard) requirements.
Attachments? Site Plan
Date: Feb 1, 2019
List Other:
Signature:
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 during its siting, construction, or operation, contact
this office immediately to determine if further review and approval of the revised project is necessary.
THIS FORM DOES NOT AUTHORIZE CONSTRUCTION WHEN A BUILDING PERMIT IS REQUIRED.
** EXPIRATION: Any zoning compliance permit issued is subject to the same expiration, suspension, and revocation provisions as a
building permit issued for the same construction permit.**
CDD Staff Certification
Date: Feb 1, 2019 CDD Staff:
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office Room # 104 - Main floor of Borough Building
After -the -Fact 2X the published amount
Not Applicable $0.00 ❑ $0.00
Less than 1.75 acres: ❑ $30.00 ❑ $60.00
1.76 to 5.00 acres: ❑ $60.00 ❑ $120.00
5.01 to 40.00 acres: ❑X $90.00 ❑ $180.00
40.01 acres or more: $12 no% EJL Ll E $240.00
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PAYMENT DATE
Kodiak Island Borough
BATCH NO.
02/01/2019
710 Mill Bay Rd.
2019-00000421
COLLECTION STATION
Kodiak, AK 99615
RECEIPT NO.
CASHIER
2019-00000866
RECEIVED FROM
CASHIER
ARCHITECTS ALASKA
Cashier
DESCRIPTION
CZ -2019-037 1915 REZANOF DR
KODIAK AK 99615
PAYMENT CODE RECEIPT DESCRIPTION TRANSACTION AMOUNT
•� ��
Payments: Type Detail Amount
Check 38721 $90.00
Total Amount: $90.00
Customer Copy
Printed hv- Cashier Pane 1 of 1 n9mlignia in•'%A-An Ann
Previous Day
Dail Activit CoKmoRAsytseaRn��ort
uis orogh
Y Y
As of 01/24/2019 710 Mill Bay Road
Company: KODIAK ISLAND BOROUGHKodlak, AK 99615
User: Dora Cross 01/25/2019 01:00 PM ET
Commercial Electronic OfficeQD F 0 Treasury Information Reporting
1/24/2019 169 / MISCELLANEOUS
Cust Ref: 0000000 000 ACH CREDIT Bank Ref: IA100604297652M%n nt: 1 /29/20190.00
Unique ID: 00000091004059060771 7
TSYS/TRANSFIRST BKCD STLMT 190123 3230168187 3230168187 KODIAK ISLAND BOROUGH
012319Q�1
Da1jY4_/ WCt'VitV1 itlF1 ��0IAL 00000POSIT Bank Ref: lA00_4.68-1065408 Credit Amount: 18,730.99
1 y H lFFlloat-Zero Day: 6,294.00 One Day: 11,920.00 Two+ Day;516.00''
DEPOSIT /
gnl�ll� p��7
Dal Aleftlt TO C A'6J'
reditAm
unt:
12,944
).,.--'"ank
4 976595
unt:
486.26(
Float -Zero Day: 9,653.00 One Day: 2,731.00
Two+ Day: 560.00
Daily Activity TofN§05Paradi m (Landfill Scale)
Float -Zero Day: 282.00 One Day: 79.00 Two+ Day: 29.00
0.00
1/24/2019 301 / COMMERCIAL DEPOSIT
! Credit Am
unt:
1,746
Dail Activit ToWi; eePr qF na C@
Twe-1.
Bank Ref: IA004685461615
Pa
0.00
DEPOSIT
(de0699,Wrect to bank by card company)
Daily Activity Totals - Lo os.Net
j
17,992.6
C st RG�, 0 000�0 Q00 j'
Bank Ref: IA006341976489
Daily Activity To�stefd��i)t0.00 One Day: 50,9:00
Two+ Day: 124.00
2,810.16
1/24/2019 301 / COMMERCIAL DEPOSIT j"
Credit Am
unt:
1,555
Cust Ker: UUUUUUUUUUU Cama Ret: imuu'io OJ4o lou/
Float -Zero Day: 1,034.00 One Day: 521.00 Two+ Da
DEPOSIT ,! ''T°8tal (should match total below) 20,802.80
.00
.60
.87
.06
1/24/2019 301 / COMMERCIAL DEPOSIT Credit Amount: 1,223.00
Cust Ref: 00000000000 Bank Ref: IA006341976
Float -Zero Day: 231.00 One Day: 926.00 Two+ Day: 66.00
�+,� DEPOSIT
Da,lV/2Qash 1QtalIS�MlERCIALDEPOSIT Credit AmqA unt 556.00
ust e : UOOOOOOOoOo Bank Ref: IA004681065350 T
Float -Zero Day: 317.00 One9a : 239.00 Two+ Day: .00
1/24/2019 301 / COMMERCIAL DEPOSIT
Cust Ref: 00000000000
DEPOSIT
COMMERCIAL DEPOSIT Total
Float -Zero Day: 19,444.00 One D(\Y,,423.00
Credit Total
PREPARED BY:a9.9bMR
F19 ��A`neDay:17,423.00
Debit Transactions �V�tU��Vfi
Deposit 1
Deposit 2
Deposit 3
).80
3.00
!.90
.75
Credit Amount:
T5.00
RAhA4M0 at1&,gtpI above) 19,883.9
Credit Amount 39,351.97
Two+Day: 2,480.00 Bank Deposit $ 19,883.92
(total less credit cards & EgOfikAljnount 39,901.97
Two+ Day: 2,480.00
Total $ - $
Page: 2
DEPOSIT /
Ca1WMERCfXL
301 L Creit Am
DEPOSIT
unt:
486.26(
Cust Ref: 00000000000 Bank Ref: IA00468106534V
Checks
Float -Zero Day: 282.00 One Day: 79.00 Two+ Day: 29.00
19,397.72
1/24/2019
301 / COMMERCIAL DEPOSIT Credit Amount:
99"g9
201
Gust Ref!
Float -Zero Day: 78.00 One Day: 130.00 Two+ Day: .00
Credit Cards
(de0699,Wrect to bank by card company)
1/24/2019
301 / COMMERCIAL DEPOSIT Credit Amount:
19;
ACH (deposit direct tef�00000 Bank Ref: IA004681065354
DEPOSIT
0.00
Cust Ref: 00000000000 Bank Ref: IA004681065348
DEPOSIT
1/24/2019 301 / COMMERCIAL DEPOSIT
Cust Ref: 00000000000
DEPOSIT
COMMERCIAL DEPOSIT Total
Float -Zero Day: 19,444.00 One D(\Y,,423.00
Credit Total
PREPARED BY:a9.9bMR
F19 ��A`neDay:17,423.00
Debit Transactions �V�tU��Vfi
Deposit 1
Deposit 2
Deposit 3
).80
3.00
!.90
.75
Credit Amount:
T5.00
RAhA4M0 at1&,gtpI above) 19,883.9
Credit Amount 39,351.97
Two+Day: 2,480.00 Bank Deposit $ 19,883.92
(total less credit cards & EgOfikAljnount 39,901.97
Two+ Day: 2,480.00
Total $ - $
Page: 2