2015, 02-17 Permit App: BLD-2015-0276 Demo ResidenceSpokane
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenteresooka neva I lev.orq
DEMOLITION PERMIT AP
PROJECT ADDRESS: /1/// S. Sow d is h
ASSESSORS PARCEL NO.:
452/4. 9/3 0
BUILDING OWNER NAME: .Boo -c/ sh Lte
MAILING ADDRESS: ///25 E. R7ifear Rd
CITY: 1/21-4/ejl rc STATE:
CONTACT PERSON NAME: Dear/ c7.6
PHONE: 509- 922- 2044 �JJ FAX: 5b9 -922-62S&
CONTRACTOR NAME: (,z-25 eit„,-/hy / i/7s7-7, ,
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
MAILING ADDRESS:
///2S e, €/mea.- Rd
CELL: I 5-09- 495- /279
�G lj
CITY: 1/4-11, ?Gni STATE: /744
PHONE: SV9-- 922. 20447 FAX: 509- 9Z2-D25b
CONTRACTOR LICENSE No.: CDs PACS 199 Cy
ZIP: 9903c,
CELL: S-09-- 995/—/279
EXPIRES 2.17 /201(0 CITY BUSINESS LICENSE NO.: 1120 137i4,3305
PROJECT DESCRIPTION (Please Provide Site Sketch)
® Site Plan Provided LI Notice of Intent # /5- 0009
El Spokane County Utilities has approved the disconnection
Describe the scone of work in detail
Rennnva/ n f%vrea
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of thls City of Spokane Valley permit Inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner In thls transaction. 4) All construction is to be done In full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit Is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required to be subm)tted Qsubsequently approved before thls application can be processed.
Signature
Method of payment: 0 Cash
0 Check ❑Visa
Bankcard #: EXP:
Date:
2/17//5
❑ Mastercard
VIN#:
Authorized Signature:
Effective October 28, 2007 - Page 1 of 1
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Demolition Permit App
10.28.07.doc
Project # f'�,'l7�Sy
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1 'SE
A CSV PERR,MP:T
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WT
SUB—`.'; REV. #
MAILING ADDRESS:
///2S e, €/mea.- Rd
CELL: I 5-09- 495- /279
�G lj
CITY: 1/4-11, ?Gni STATE: /744
PHONE: SV9-- 922. 20447 FAX: 509- 9Z2-D25b
CONTRACTOR LICENSE No.: CDs PACS 199 Cy
ZIP: 9903c,
CELL: S-09-- 995/—/279
EXPIRES 2.17 /201(0 CITY BUSINESS LICENSE NO.: 1120 137i4,3305
PROJECT DESCRIPTION (Please Provide Site Sketch)
® Site Plan Provided LI Notice of Intent # /5- 0009
El Spokane County Utilities has approved the disconnection
Describe the scone of work in detail
Rennnva/ n f%vrea
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of thls City of Spokane Valley permit Inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner In thls transaction. 4) All construction is to be done In full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit Is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
Information may be required to be subm)tted Qsubsequently approved before thls application can be processed.
Signature
Method of payment: 0 Cash
0 Check ❑Visa
Bankcard #: EXP:
Date:
2/17//5
❑ Mastercard
VIN#:
Authorized Signature:
Effective October 28, 2007 - Page 1 of 1
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Demolition Permit App
10.28.07.doc
SRCAA, 3104 E. Augusta Ave., Spokane, WA 99207 / www.spokanecleanair.org / Ph:(509)477-4727 Fax: (509) 477-6828 10/14/14
(, 1
15- oonq
a
FEB 1 7 2015
Notice of Intent No.
Agency Use Only
Cv ,.
Spokane
Ctean Air.,...-,
N O T IIC E OF. INTENT? ,
,__., --
• FOR Atilt CSTOSPRO.IIU':'I'S /DI \IOI IIION'r
_
= _ . _ _
.S®Qr'Q Only
J
-
Review Spokane Regional Clean Air Agency SRCAA) Regulation I, Article IX and Section 10.0
• pp 1 a.
e requiremen ..
A. Project Type:
❑ Asbestos Removal
1A. Asbestos Removal & Demolition
❑ Demolition, No Asbestos Removal
Does this project involve a fire -damaged structure?:
• Yes Is,No
(If yes, refer to Sections 9.03.F.3 and 9.08)
Does this project involve demolition by fire training?:
• Yes IJ No
(See Sections 9.02.L, 9.03.F.4 & 9.04.A.6.0
How many contiguous structures does this project involve'?:
0 ix t
Maximum of 5 structures per Notice of Intent (NOI)
B. Property Owner:
Bocoitsl-t L.L.C.
Phone:
509,922-204y
Fait:
SOY- al22 O2S'o
Mailing Address:
11125 E. RihearRd.
City:!
-VallryFord \. ?:State:
WA}
Zip:
9903 ea
C. Site Address
Contact Person:
Dean Scelbej -.
Job SitePhooe:
.2)9_9414-1279
Structure #1:
I Li 1 1 S, Bo odtsh 1-1-orne.
If>1 structure, provide details to identify
#2:
#3:
#4:
#5:
D. ❑Material
Presumed
12Asbestos
Survey:
Date survey performed
1/31/2015"
AFIERA Bldg. Inspector Name:
Douglas C-,eier_
Was asbestos found?
❑ Yes ❑ No
Company:
AAA of Spokane-
Cert. No.:
B1 g -14-1111
E. Asbestos
Removal
Start
Date:
2/2. /2015
Completion
Date:
2 RI 12015
For each structure listed in section C, itemize the type and
quantity of asbestos -containing materials to be removed.
Also indicate which structure(s) will be demolished.
Do materials include disturbed or non -intact asbestos?
0 Yes 1S No
�rm
Poprern et; /t^ri�q J.iu,4,. , Ki&Shen Yellow 1✓/oorVinyl fSub1'ioor . Bath roorn [-Icor l/riyl
Tin La�1erand Bt c& bathe Eyder,lir elemend' .200 -rd Sd/hj
,
Total Linear Feet:
Total Square Feet:
1743
Abatement By ( f known):
Owne-rs
F. Demolition Information
Start Date: (earliest)
2/ 2 3/ I S
Demolition By
(if known):
Owners
G. Asbestos Project & Demolition Notification Wa'ting Period and Non -Refundable Fee Categor'es (additional categories - pg. 2)
Your advance notification period will begin when a completed NOI, including required fees, is received by SRCAA.
Check / com.lete all boxes which a. .1 , below.
Owner -occupied sings,'-tlnulc residcnet (refer to.Renovation.and Demolition information- shict) ' Wailing Period:,
1. ❑ >_ 10 In ft and/or 2 48 sq ft asbestos project NOT performed by residing homeowner Prior Notice
�-" f i
$0 .
2. .1 All Demolition (all asbestos must be properly removed and disposed of prior to demolition) 3 Days
i Notowner-occupied, singli,:ramily residence"-.' ,_ . _-•Waiting.PPriod.
3. ❑ < 10 In 11 and/or < 48 sq ft making total per structure, per calendar year 10 In ft and/or >_ 48 sq ft Prior Notice
$30
pec
$75
4. ❑ 10-259 In ft and/or 48-159 sq ft asbestos 3 Days
$250
5. ❑ 260-999 In ft and/or 160-4,999 sq ft asbestos 10 Days
$500
6. 0 2 1,000 In ft and/or 2 5,000 sq ft asbestos (see below if 2,000 In ft or >_ 10,000 sq ft) 10 Days
$1,250
If 2 2,000 In ft or >_ 10,000 sq ft, the additional incremental fee added to the $1,250 base fee is calculated as the greater of:
Number of 1,000 In ft increments beginning at 2,000 In ft:
_ x $250 =
$
+ $1,250 base fee =
$
Number of 10,000 sq ft increments beginning at 10,000 sq ft: _ x $250 = $ + $1,250 base fee =
$
7. ❑ All Demolition (this fee waived if project performed with project category 4, 5, or 6, above)
10 Days
$250
H. Acknowledgement - Refer to page 3.
CZ Check here to indicate you have read and accept the acknowledgement in Part H on Page 3.
Business Name&Address: Bowdisk 1112SE,RiriearRd,V0-II d, IJP g4o3to Fax: so9-92-20Cii
(��jLLC
.2:1_,..2,..)._,...y
yPrint Name: Dean ,Sc iberq Phone: Soo -422-2oµ¢
Signature: t+"' .1 _,..-
Agency Use Only:
❑ NOI De tcient (see page 2) U (Date & Initial)
I] NOI Complete (Date/Iniliap
Page 1 of 3
SRCAA, 3104 E. Augusta Ave., Spokane, WA 99207 / www.spokanecleanair.org / Ph:(509)477-4727 Fax: (509) 477-6828 10/14/14
(, 1
Projedt #1-----
;:..,.REC.EIVED
FEB 172015
..CSV PERMIT CENTER
SUB # REV. #,�
Receipt: 9661
Acct #: 2356
Spokane Regional Clean Air Agency
3104 E Augusta Ave
Spokane, WA 99207 5384
Bowdish LLC
11125 E. Rinear Rd
Valleyford, WA 99036
02/17/2015
Treasurer's Receipts
Memo 15-0009 1411 S. Bowdish Home
15-0009 1411 S. Bowdish H
Non Taxed Amt:
Total:
Cash:
30.00
30.00
30.00
30.00
Tti Tendered:
Change:
Issued By: Deb R
02/17/2015 11:39:13
30.00
0.00
Project r d.C�*a.9(5'O 7,1:9
.RECEIVED
FEB 1 7 2015
X34'
E---,
4_