USS 2538A LT 3 JR HIGH - ZCP 3/3/2011Kodiak Island Borough
Community Development Department
710 Mill Bay Rd. Rm 205
Kodiak AK 99615
Ph. (907) 486 - 9362 Fax (907) 486 - 9396
http://www.kodiakak.us
Zoning Compliance Permit
Print Form
1111
111
16191
11
111
Permit No. CZ2011 -042
ubmit by Email
Property Owner / Applicant:
Mailing Address:
Phone Number:
Other Contact email, etc.:
Legal Description:
Street Address:
The following information is to be supplied by the Applicant:
Kodiak Island Borough
710 Mill Bay Rd., Kodiak, AK. 99615
c/o 1.907.486.9349
USS 2538A Lot 3
1021 E. Rezanof Dr
Use & Size of Existing Structures: Middle School complex
Description of Proposed Action: Seismic upgrades to Middle School Gymnasium
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: 4.85
Front Yard: Not Applicable
ZONING: LI Prop_ID 16191
Lot Width: Not Applicable Bld'g Height: Not Applicable
Rear Yard: Not Applicable Side Yard: Not Applicable
Prk'g Plan Rvw? No # of Req'd Spaces:
Plat / Subdivision
Requirements?
Does the project involve
an EPA defined facility?
If YES, do you have an EPA Return Receipt of Notification?
YES "Permit will not be issued until receipt is submitted to KIB" YES
Coastal Policy Other Consistent? Yes Attachment?
Subd Case No. Plat No. Bld'g Permit No.
Driveway
Permit?
Septic Plan
Approval:
Fire
Marshall:
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? Site Plan
Date: Mar 3, 2011
List Other:
Signature: Jessica Wolfe
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.
** EXPIRATION. A zoning compliance permit will become null and void if the building or use authorized 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. **
Payment Verification
Zoning Compliance Permit Fee
Payable in Cashier's Office
Room # 104
Fee Schedule
1.76 to 5 acres $60.00
Construction Disposal Deposit
Payable in Cashier's Office
Room # 104
Fee Schedule
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3909 Arctic Blvd., Suite 400
Anchorage, AK 99503
(907) 222 -9500 # fax (907) 222 -9519
Jason Pavitt, March 3, 2011
Asbestos NESHAP Coordinator
Alaska Operations Office222 W. 7" Ave M/S #19
Anchorage, AK. 99513
Jason,
Aluitiq International Solutions (AIS) is the General Contractor for the Kodiak Middle
School Seismic Upgrades.
Scope of Work: The work includes removal of existing suspended ceilings, wall and
ceiling mounted equipment, ductwork, gymnasium floor protection and other existing
assemblies as required to install additional seismic bracing. At the underside of the
existing gymnasium roof structure. Work also includes: installation of additional
structural bracing, ceiling panels and lighting; re- installation of existing mechanical
ducts, diffusers, piping and related equipment; removal of protection from existing gym
floor.
The owner has indicated in addendum #2 of the RFP the following: "Section 01732,
Selective Demolition, 1.7C: Hazardous Materials: Hazardous Material are not known to
exist in the area to be selectively demolished."
As such we do not anticipate have an individual trained in NESHAP on site during the
renovation.
Please contact me regarding any question or concerns.
Regards,
Pa I Winkler
Alaska Branch Manager
Alutiiq LLC
3903 Arctic Blvd. Suite 400
Anchorage, AK 99503
907 - 762 -9466
Page t of 2
Operator Project #
Postmark
Date Received Notification #
I. Type of Notification (check one): Original Revised Canceled
IL Facility Description
Building Name: Kodiak Middle School
Address: 1017 Rezanof East
City: Kodiak State: AK Zip Coder 99615 County:. Kodiak Is. Cou nty
Site Location: Kodiak Island, USA
Building Size (square feet): 9000 sf (gym) # of Floors: 2 Story Age in Years: 68
Present Use: Middle School (Public) Prior Use: None
III. Type of Operation (check one): Demo Ordered Demo 7 Renovation M Emergency Renovation 17 Fire Training
1V Is Asbestos Present? (check one); Yes 7No
V. Facility Information
Owner Name: Kodiak Island Borough
_
Address: 710 Mill Bay Road
City: Kodiak State: AK Zip Code: 99615
Contact: Ken Smith Telephone: 9( 07) 486 -9349 Fax: (907) 486 -9347
Removal Contractor Name: N/A
Address:
City: State: Zip Code:
Contact: Telephone: (�) Fax:
Other Operator (demolition/general): Alutiiq International Solutions, LLC (General Contractor)
Address: 3909 Arctic Blvd. Suite 400
City: Anchorage State: AK Zip Code: 99503
Contact: Eric Adams Telephone: 9L0) 762 -9485 Fax: (907) 222 -9519
VI. Procedure, including analytical methods, employed to detect the presence of and to estimate the quantity of RACM and
Category I and Category II non - friable ACM:
** See attached cover letter.
VII. Approximate Amount of Asbestos Materials:
Non - friable Asbestos Material
Non - friable Asbestos Material
RACM to be Removed
to be Removed
NOT to be Removed
Category I
Category II
Category I
Category 11
Pipes (linear feet)
0
Surface Area (square feet)
0
Facility Components (cubic feet)
0
VIII. Scheduled Dates Demolition or Renovation: Start: 05/19/11 Complete: 08/19/11
W_ Dates for Asbestos Removal (MM/DD/YY) Start: Complete:
Days of the Week:
Monday
Tuesday
I Wednesday
Thursday
Friday
I Saturday
Sunday
Hours of Operation:
Page 2 of 2
X.
Description of planned Demolition or Renovation work to be performed and method(s) to be employed, including demolition
or renovation techniques to be used and description of affected facility components:
Removal of existing suspended ceilings, wail and ceiling mounted equipment, dud work, gym floor protection and other protection as required to install additional structural
bracing
at the underside of the existing roof structure. installation of new ceiling panels and lighting, re- Installation of existing ,mechanical ducts, diffusers and associated
components.
XI.
Description of work practices and engineering controls to be used to comply with the requirements, including asbestos
removal and waste handling emission control procedures:
NIA
X1I.
Waste Transporter #1
Name: N/A
Address:
City: State: Zip Code:
Contact: Telephone: ( )
Waste Transporter #2
Name: N/A
Address:
City: State: Zip Code:
Contact: Telephone: { )
X111.
Waste Disposal
Name:
Address:
City: State: Zip Code:
Contact: Telephone: ( )
XIV.
Emergency Demolition (complete Item XIV only if this project is an Emergency Demo.)
1. Attach a copy of the Order to this notice,
2. Name of Authority Issuing Order: Title:
3. Authority of Order (Citation of Code):
4. Date of Order (MM/DD/YY): Date Ordered to Begin
XV.
Emergency Renovation (Attach separate sheet with the following information if project is Emergency Renovation.)
1. Date and Hour of the Emergency:
2. Description of the Sudden, Unexpected Event:
3. Explanation of how the event caused unsafe conditions or equipment damage or an unreasonable financial burden.
XVI.
Description of procedures to be followed in the event that unexpected RACM is found or non - friable ACM becomes
crumbled, pulverized, or reduced to powder.
XVH.
I certify that an individual trained in the provisions of NESHAP (40 CFR PART 61, SUBPART M) will be on -site during the
Demolition or Renovation, and evidence that the required training has been accomplished by this person will be
available during normal business hours.
Signature of Owner /Operator Date Type or Print Name and Title
XVIH.
I acknowledge the existence of laws prohibiting the submission of false or misleading statements, and I certify that facts
contained in this notification are true, accurate, and complete,
? Paul Winkler
Anchorage Branch Manager
Signature of Owner /Operator Dat( Type or Print Name and Title