2008, 05-01 Permit App: 08001626 DemoProject Number: 08001626 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/1/2008 Page 1 of 2
Project Information:
Permit Use: DEMO OLD HOUSE Contact: ZUYEVA, ANYA/MISHAKOV, ANDREY
Address: 3404 E 34TH AVE
C - S - Z: SPOKANE, WA 99223
Setbacks: Front Left: Right: Rear: Phone: (509) 939-5600
Group Name:
Site Information: Project Name:
Plat Key: Name: OPPORTUNITY 01ST ADD District: Nort
Parcel Number: 45172.0910
SiteAddress: 9407 E BOONE AVE
Location:: CSV
Block: Lot:
Zoning: UR -3.5 Urban Residential 3.5
Water District: 011 MODERN
Area: 21,300 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Owner: Name: ZUYEVA, ANYA/MISHAKOV, AND
Address: 3404 E 34TH AVE
SPOKANE, WA 99223
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Released By:
Originally Released:
Other Reviews
5/1/2008 By: jdavis
Released By:
Sewer Review
Permits:
Originally Released:
5/1/2008 By: jdavis
Released By:
PER ROGER RIVERS
Originally Released: 5/1/2008 By: jdavis
Operator: JD Printed By: JD
Print Date: 5/1/2008
Project Number: 08001626 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/1/2008 Page 2 of 2
Demolition Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
Item Description Units Unit Desc Fee Amount
DEMOLITION - RESIDENTIAL 1 NUMBER OF $44.00
Notes:
Payment Summary:
Permit Type
Demolition Permit
Permit Total Fees: $44.00
Fee Amount Invoice Amount Amount Paid Amount Owing
$44.00 $44.00 $0.00 $44.00
$44.00 $44.00 $0.00 $44.00
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: JD Printed By: JD Print Date: 5/1/2008
Spokane
.Valley
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
w, w.spokanevalley.or2,
Demolition
Permit Application
PERMIT NUMBER: /47Z (.p
PERMIT FEE:
Commercial
Residential
`T41
SITE ADDRESS: Q W) 7 C & ne "ye. �2O,E6
ASSESSORS PARCEL NO:
Building Owner:
Z 2 G
Name:
ff
Address: �� .�/b
Lc m2,55,6‘., ` yc/
City: c.� �)0v/6_,-
,_.€
State: Gt,/,4, Zip: =cr2/;4
Phone: f.
S-6 6c, Fax:
Contact Person
Name: A wof vim-, /t1; s t
Phone: q 3 "S�v 0-O
Contractor: rope ue_._ JL
Z 2 G
Name: ctp,,e7, ri,(454,2,k,✓
Address: 3y'D ,P L` 34,0 7ve
City: C.)/ -c e State: ze,//
Zip:,.
-L--,6
Phone:
Phone: ( %) cl3 , SZav Fax:
Contractor Lic No: Exp Date:
City Business Lic. No: U R ®P RL S--6
Describe the scope of work in detail
/ee,(4-e c ve (T2 / / S 6 Gt
P2 -' /D° / u>
=}y o A site plan is provided.
o Spokane County Utilities has approved the disconnection.
o Notice of Intent # - 6/07
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 development rights granted by any issued permit inure to the property owner.
Signature
Date
Method of Payment:
❑ Cash ❑ Check ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/16/07
ra J•••••••61.16.110•14
n
SRCAA NOI No.
03' 0 (07
Agency Use Only
SPOKANE REGIONAL CLEAN AIR AGENCY (SRCAA)U
1101 West College, Suite 403, Spokane, WA 99201J
NOTICE OF INTENT (NOI)
For Asbestos Projects and Demolition Projects
•
L `�-RIrf eeved By SI�CAA
ate
4 j= 5 2008
SPOKA fit
CLEAN AIR ACCNCY
A. Project Type:
1. ❑ Asbestos Removal
2. ❑ Asbestos Removal & Demolition
Vid.Demolition,
No Asbestos xemoval
B. Property
Owner: 'req Mi36E..._0,./
v1c1 k.iPhone:(6
_0c1)g3q'S57)a
(If available)
Fax:
Property Owner's =�: G '
Mailing Address: Rfaggi Q. 9yo7 e Rd, a `ce
City: s po kavu _
State: W A
Zip: 9a 2-
C. Site �-y
Address: q'1 c, 7 C Be._37l'.L�
City: 5l � z ci, ,4
State: v\in
Zip: q q 2.t7 6,
Responsible SiteJob
Contact Person: /Y1 C' cit /Z�.a o V
Site
Phone: f' Z7' /l'.,5`1 —375 G
D. G Asbestos Survey or
❑ Material Presumed
If survey erformed, was asbestos found?
4es LI If "No" for any structure, attach survey
Date Survey
Conducted: ,0V . oj,
a
No. of Structures: i
(see back if >1)
AHERA Building/ 77
Inspector Name: �2r / 0 e. #- 9
Certification
Number: 356 r — 07
— 1/ — "6
Exp.
Date: //-16-6
E. Asbestos Project
Information:
No. of Structures:
(see back if>1) /
Start
Date:
Completion
Date:
Wk. Days: Su M T W Th F Sa
Hours:
Total quantity
to be removed:
Ln.
Feet
Sq.
Feet
Will all asbestos material be ❑ Yes
removed by project completion? ❑ No
Will work schedule ❑ Yes
fax pgm. be used? ❑ 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) /
Start g--,l47-0E
Date:
Fire (List Fire Dept. as demo. contractor below)
❑ Ordered Demolition (attach copy of Order)
Demolition
Contractor: Aielte`i /7/%5 iter460 ✓
Phone(L-'9)5039'5 d
Fax:
Mailing"JAL
Address: Address: 9%) 7 iia
City: c....-7 aie--e
State:
Zip:
G. Asbestos/Demolition Project Categories:
Notification
Waiting Period
Non -Refundable
Project Fee
Does this project involve a fire -damaged structure? ❑ Yes No
1. wner-Occupied, Single -Family Residence Asbestos & Demolition Project *
Owner -Occupied, Single -Family Residence Demolition Project
Prior Notice
$30
2. ❑ All Other Demolitions With No Asbestos Removal Project
10 Days
$250
3. ❑ 10 - 259 linear feet or 48 - 159 square feet (see back of form for options)
3 Days
$250
4. ❑ 260 - 999 linear feet or 160 - 4,999 square feet
10 Days
$500
5. ❑ > 1,000 linear feet or > 5,000 square feet
10 Days
$1,250
6. ❑ Emergency Asbestos/Demolition Project (attach "owner's letter")
Prior Notice
Twice Project Fee
7. ❑ Alternate Means of Compliance for Friable Materials (attach plan)
10 Days
Twice Project Fee
8. ❑ Alternate Means of Compliance for Nonfriable Materials (attach plan)
10 Days
Twice Project Fee
9. ❑ Exception for Hazardous Conditions (attach plan)
Concurrent with Project
Regular Project Fee
10. ❑ 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 NOI and/or related notices sent to (list name & fax number and/or mailing address):
I. I certifythat the information contained in this notification and anysupplemental dataprovided is to the best of
pp
my know dge, accurate and complete.
e:74.. /fr 0 6,-1----- ,% y4 //,5 ` c / 9 , --yep
Cpleteness Review
=�� NOI complete
NOI deficient -
See Attached
v ` Signature Representing Date
For demolition projects, this NOI expires 12 months from the earliest listed asbestos/demolition project start date.Li-m-eP
P
Agency Use Only
Your advance notification period will begin when a completed NOI, including required fees, is received by SRCAA.
A copy of the asbestos survey, completed notification & all amendments must be available for inspection at all times at the job site. NOI 7/07