If KIOO could move just a bit north but much higher than they currently are, how close could they get to KMAK without violating spacing/distance rules?
Yea, because of the class of KKBZ and KCRZ they both can have good elevation and still cover similar areas.
Regarding KIOO, KCIV 99.9 is more of a concern than KMAK. It's a full class B north of Fresno but it puts a 60 dBu signal nearly into Madera and a 50+/- dBu signal into Fresno.
Any further north or a raise in elevation would most likely create issues.