2008, 02-13 Permit App: 08000318 Demo BarnSpokam
#Valley°
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 992 CEIVED BY
(509)688-0036 FAX: Lc
m )681¢ pKANE VALLEY
v. -, .sookanevalley.ors
Demolition
Permit Application
Y
FEB 0 5 2008
PERMIT CENTER
PERMIT NUMBER:T- Q
PERMIT FEE:
Commercial
Residential
SITE ADDRESS
/11 / N IA A /1141 /et'
ASSESSORS PARCEL NO: Pgr.ai ho 137t2,/0c
/b Soz E t3oonc
Building Owner. /11:- . '
Contractor:' fii
Name: n// Jt e e y m vx
Name:
Address: 1 we / /� /JS/re 4
Address:
City: // (e7�/t l c _ i State: ), /� Zip: 14.03"
Of
City: State: Zip:
Phone: Fax:
y8/, vv/s
Phone: Fax:
Contractor Lic No: Exp Date:
Contact Person .,'; ,..
City Business Lic. No:
//
Name: At At
, 4/Pr .hw ),
Phone: / 9/ - Wsr
Describe the scope of work in detail
Lell a3 -C Aloe' Sc4r,1
o A site plan is provided.
o Spokane County Utilities has approved the disconnection.
o Notice of Intent #
The permittee verifies, acknowledges and agrees by their signature that: 1) Ownership of this City of Spokane Valley
Permit inure to the property owner. 2) The signatory is the property owner or has permission to represent the property
owner in this transaction. 3) All construction is to be done in full compliance with the City of Spokane Valley
Development Code. 4) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances.
Ownership of resulting develop ent rights granted by any issued permit inure to the property owner.
Signature,!is 2/1 Date 7- J - w
Method of Payment:
❑ Cash ❑ Check ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/16)07
Project Number: 08000318 . Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/13/2008 Page 1 of 2
Project Information:
• Permit Use: 'DEMOLITION OF HORSE BARN Contact: ACKERMAN, MIKE
Address: 10802 E BOONE AVE
C - S - Z: SPOKANE VALLEY, WA 99206-4802
Setbacks: Front Left: Right: Rear: Phone: (509) 981-4415
Group Name:
Site Information: Project Name: NOTICE OF INTENT #08-0037
Plat Key: CONV Name: CONVERTED CNTY DATA District: Nort
Parcel Number: 45162.1068 Block:
Lot:
SiteAddress: 10802 E BOONE AVE Owner: Name: ACKERMAN, MIKE
Address: 10802 E BOONE AVE
Location:: CSV SPOKANE VALLEY, WA 99206-48
Zoning: R-4 SF Res Urban District
Water District: 011 MODERN Hold: ❑
Area: 43,560 Sq Ft Width: 348 Depth: 132 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: _ u
Review
Building Plan Review
Released By:
PER APPROVED NOI - 08-0037 - MT
Sewer Review
Originally Released: 2/12/2008 By: MTURBAK
Released By:
PER R.RIVERS - UTILITIES - VIA FAX - 2/5/2008 - MT
Originally Released: 2/5/2008 By: MTURBAK
Permits:
Demolition Permit
Contractor: OWNER
Item Description
DEMOLITION ACCESSORY
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
Operator: jmm Printed 13y: jmm
Fee Amount
$20.00
Permit Total Fees: $20.00
Print Date: 2/13/2008
Project Number: 08000318 . Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 2/13/2008 Page 2 of 2
Notes:
FOR 10705 E BROADWAY & 10725 E BROADWAY (SHP-37-06), A 6 FOOT HIGH SIGHT
OBSCURING FENCE MUST BE INSTALLED ON THE WEST, NORTH & EAST PROPERTY
LINES PRIOR TO ANY BUILDING PERMIT -MH
Payment Summary:
Permit Type
Demolition Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$20.00 $20.00 $0.00 $20.00
$20.00 $20.00 $0.00 $20.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed By: jmm
Print Date: 2/13/2008
SRCAA NOI No.
O•
Agency se Onty�7
SPOKANE REGIONAL CLEAN AIR AGENCY (SRCAA)
1101 West College, Suite 403, Spokane, WA 99201
NOTICE OF INTENT (NOI)
For Asbestos Projects and Demolition Projects
11
ate Received By
FEB 0 5 2008
SG�g1R qi
SRCAA
_ AL
A. Project Type:
1. ❑ Asbestos Removal
2. ❑ Asbestos Removal & Demolition
3. ktDemolition, No Asbestos Removal
B. Property//
Owner: �, c , jcrc2 r 'Y/ e ,;
_
Phone: 78/• yf/3
(If available)
Fax:
Property Owner's C
Mailing Address: //Z / ,S /f0.h �c,�z r
City: ;,2
/4/7,7
State: A/
�
Zip: g ,93 j,
C. Site
Address: /// /j/ // / ���
/
City: 6 "0%n,
;,i
1//at/7 h/7/
Zip: 9 'J
Responsible Site
Co tact Person: 4,/I p c,P,- /12 F n <..i---
Job Site t�{
Phone: 9c5/ • Y /j
D. AAsbestos Survey or
❑ Material Presumed
{�`
I�fy$urvey erformed, was asbestos found? 52' `'v`
yp.Yes LJ If "No" for any structure, attach survey
Date Survey
Conducted: 01/4'6_i,
No. of Structures:
(see back if>1) /
AHERA Building / /
Inspector Name: , I.,( ) - cJ
Certifcation
Number: /3/±� - 8, - 071
Exp.
Date? 4:52-62,g,
E. Asbestos Project
Information:
No. of Structures:
(see back if> )
Start
Date:
Completion
Date:
Wk. Days: Su M T W Th F Sa
Flours:
Total quantity
to be removed:
Ln.
Feet
Sq.
Feet
Will all asbestos material be U Yes
removed by project completion? 0 No
Will work schedule LJ Yes
fax pgm. be used? 0 No
List individual type and quantity of materials to
be removed or provide an attachment of same:
Abatement
Contractor:
Phone:
Fax:
Mailing
Address:
City:
State:
Zip•
F. Demolition
Information:
No. of Structures:
(see back if> 1) I
Start ,,/
Date: /// to b
0 Training Fire (List Fire Dept. as demo. contractor below)
0 Ordered Demolition (attach copy of Order)
6)
p.
Demolition Ai..
Contractor: /1,/-c_ l' , /.P r el.a h
Phone: /b'/'/S�
/'�
Fax:
Mailing / /
Address: 5 9/Zl j/J('r1 CGhc.
City: Yt'V4 /
State:VI
Zip: 190f
G. Asbestos/Demolition Project Catego ies:
/ Notificat on
Waiting Period
Non-Refundable
Project Fee
Does this project involve a fire-damaged structure? U Yes U No
1. U
Owner-Occupied,Single-Family Residence Asbestos & Demolition Project *
caner-Occupied, Single -Family Residence Demolition Project *
prior Notice
$30
2..
All Other Demolitions With No-Asbestos Removal Project
10 Days
$250 J
3. LJ 10 - 259 linear feet or 48 - 159 square feet (see back of form for options)
3 Days
—5230
4. U 260 - 999 linear feet or 160 - 4,999 square feet
10 Days
$500
5. U > 1,000 linear feet or> 5,000 square feet
10 Days
$1,250
6. U Emergency Asbestos/Demolition Project (attach "owner's letter-")
Prior Notice
Twice Project Fee
7. U Altemate Means of Compliance for Friable Materials (attach plan)
10 Days
Twice Project Fee
8. LJ Alternate Means of Compliance for Nonfriable Materials (attach plan)
10 Days
Twice Project Fee
9. 0 Exception for Hazardous Conditions (attach plan)
Concurrent with Project
Regular Project Fee
10. U Demolition with Nonfriable Roofing Left in Place
10 Days
Twice Project Fee
* The two categories in G.1 apply only to owner-occupied, single -family residences, which means any non-multiple unit bui ding containing living
space that is currently occupied (prior to and after renovation/demolition) by one family who owns the property as their domicile. One of the
categories must be used for all other asbestos/demolition projects. For more information, contact SRCAA at (509) 477-4727.
H. Optional: List additional parties you would like copies of this 1401 and/or related notices sent to (list name & fax number and/or mailing address):
..Co
/SOI
1. I certify that the information contained in this notification and any supplemental data provided is, to the best of
myowl dge, accurate d complete.
A
I Ro/ 2 S O14'
m leteness Review
complete
❑ NOI deficient -
See Attached
'J� Signature�i�`" `"1 Representing Date
For ad-EMI.projects,projects, this NOI expires 12 months from the earliest listed asbestos/demolition project stars date.
/
� (f 3/4u
Agency Use Only
Your advance notification period will begin when a completed NOI, including required fees, is received by SRCAA. D
o. e e . o„ rn,nnlete,t nntifratinn x. all amendments meat he available for inspection at all times at the job site. NO 7/07
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Feb 05 2008 4:30PM
SPOKANEttCOUNTY2tUTILITIES 4777178
P.
11703 E Sprague Ave Suite 0.3 ♦ Spokane Valley WA 94206
• 509.668.0036 • Fac 509.680.0037 •
Transmittal
Date: V1512008
>i SPOKANE COUNTY UTILITIES
Fac 509-477-4715
CSV PERMIT CENTER
Re: RsvlewlApprr.al of Demolition Permit Application
Attn: Billy Urbausen
Nt Roger Rivers
Glen Gredvig
Colin Depner
Lela Gallen
SITE ADDRESS: 10802 E BOON
PERMTr PURPOSE: DEMOLITION OF HORSE BARN
T414-Inorse.,6041-n I5nok c-onnu.44.1 Aso �
1Car/A Ase1an.?•
A sewtr AiriO aisn Mem .rrntj S i Ye.coal sa•
—7‘i vGrS
1-11-'74$2
5479
FEB 05 2008 16:27
4777178 PAGE.01