USS 3218 TR R-2A - ZCP 5/5/2021Kodiak Island Borough Print Form Submit by Email
Community Development Department
,rc 710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9363 Fax (907) 486 - 9396
http://www.kodiakek.us
Zoning Compliance Permit Permit No. CZ I
The following information is to be supplied by the Applicant:
Property Owner / Applicant: Yukon Fire Protection Services I K a N A
Mailing Address: 5601 Silverado Way Anchorage, AK 99518
Phone Number: 907-563-3608
Other Contact email, etc.: mpeterson@yukonfire.com
Legal Description: Subdv: Block: Lot:
Street Address: 3449 E. Rezanof Drive '
Use & Size of Existing Structures:
Existing KANA Clinic approximately 19000 square feet.
Description of Proposed Action:
Add / Relocate 21 automatic fire sprinklers to accommodate the addition of new cubicle partitions.
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: Current Zoning: 3 U S PROP —ID i (0 3ya-
Lot Area: 3 \ `J Lot Width: Bld'g Height: �U
Front Yard: Q Rear Yard: N 1� Side Yard:
Prk'g Plan Rvw? \ # of Req'd Spaces:
Staff Compliance Review Notes and Specific Plat / Subdivision Requirements:
5u __se No. ;°l • #i4 Plat No. Bld'g Permit No.
Does the project involve
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:
Proof of EPA notification provided (if required)?
'Required for all demolitions, for renovations disturbing at least 160 square
feet, 260 linearfeet, or 35 cubic feet of Regulated Asbestos Containing Material (RACM), and
for renovations that remove a load -supporting structural member.
No permit wiU be issued for such proiects without proof of EPA notification
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 for verification of building setback (yard) requirements.
Attachments? Not Applicable List Other:
Date: Apr 29, 2021
Signature: Michael Peterson
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
I n 1k
Date: 5 /3i a I CDD Staff:
Payment Verification Zoning Compliance Permit Fee Payable in Cashier's Office mom # 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:
R$90.00
$180.00
40.01 acres or more:
F$120.00
$240.00
Erin Welty
From: Steven Smith <Steven.Smith@kodiakhealthcare.org>
Sent: Saturday, May 1, 2021 9:26 AM
To: Erin Welty
Subject: Yukon Fire
I did get your voice mail message. I am out of town in Seattle.
Please consider this email as official direction to authorize that Yukon Fire as an approved authorized permit request
representation on behalf of KANA for our main sprinkler remodel project at 3449 Rezanof Drive.
Thank you.
Sent from my iPhone
CONFIDENTIALITY STATEMENT: This may contain confidential, protected health information or information that is legally
privileged. This information is intended only for the use of the individual or entity listed or addressed. If you are not the
intended recipient you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the
content of these documents is strictly prohibited. If you have received this information in error, please notify the sender
immediately and arrange for the return or destruction of these documents.
v-t'UJ - I ratlsaction Keceipi
Transaction Receipt - Success
Kodiak Island Borough
Kodiak Island Borough Community Development
MID:200006988265
710 Mill Bay Road
Kodiak, AK 99615
907-486-9323
05/05/2021 10:41 AM
Remittance ID:
Kodiak050521143926692Wel
Transaction ID:
268117778
MICHAEL PETERSON
5601 Silverado Way
ANCHORAGE, Alaska 99518
United States
MasterCard - 6598
Approval Code: 005461
Sale
Amount: $60.00
KANA/Yukon Fire Protection Services
907-563-3608
CZ2021-056
3449 E. Rezanof Drive
Service Fee: $1.50
Service Fee Type: Dual Transaction
Total Amount: $61.50
Cardmember acknowledges
receipt of goods and/or
services in the amount of
the total shown hereon and
agrees to perform the
obligations set forth by the
cardmember's agreement with
the issuer.
Signature
click here to continue.
httn—//volnrihinavmont rnm/nrlmin/Irnrlinlralr/vnnc/ AQF7/trmncnrtinne/rcroint/7PavmontlfL7RR11777A 1 11