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2008, 10-09 Permit App: 08004021 Demo HouseSpokane Valley& Community Development Demolition Permit Application SITE ADDRESS: tae 4/, /A ASSESSORS PARCEL NO: Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www . spokan evalley. ore, Building Owner: Name: r� Address: 2O05 / City:s G ifyf (%ride% SPC% ' /State: s Phone: /?/ —CO 5 G Contact Person Name: lob co VI c Phone: �r ❑ Commercial Residential X es n F190e. NG Zip: 7ftY/ Fax: ern -C9©S f' Describe the scope of work in detail wfs ifre will Contractor: C'orii w 141.7 Name: se, , eat/ - 9 Address: X32 �/ •, eef 44 cP #zza State: C!% Zip: ffey City: Phones o /91- OOS Fax: Co 7 89/-0057 C Exp Date:�c.3--o/ O Con • ctor Lic No: N ' • City Business Lic. No: C? — s S / ever 9l/ cF 144 VA site plan is provided. %Spokane County Utilities has approved the disconnection. Notice of Intent # 0 % —0 3 (.1 The permittee verifies, acknowledges and agrees by their signature that: 1) Ownership has rshippermiof thission to Cityrepof Spokt the erValleyy Permit inure to the property owner. 2) The signatory is the property owner in this transaction. 3) All construction eisPe � it is not a done In full compliance with the permit or approval for any violation lof federalest Valley or Development Code. 4) This City of Spokane Val y local laws, codes or ordinances. Ownership of resul Signatur Method of Payment: ❑ Cash Bankcard #: Authorized Signature: nt rights granted by any issued permit inure to the property owner. Date ❑ MasterCard Expires: ❑ VISA VIN#: Effective 10-28-07 Page 1 of 1 P:\Community Development\Forms\Building forms\Demolition Permit Application.doc OCT 0 ' 2000 57' 2005 Hodges Ln. (existing fire damaged house) / / 19' ♦— 12' — Existing 4-- Driveway sidewalk Hodges Lane Uct. 9. IVUU 1:i rm ar.m'ir.c. 1.LL%ly n11� 0 8•03Zii Notice of Intent No_ NO O ■ lCE OF INTENT From:D_ebbie RileyV.—.. IU u OCT 0 7,Z008 The $250 demolition fee is waived if demolition u performed in conjunction with asbestos project category 2.3 or 4, above. H. Optional: List additional parties you would like copies of this NOl and/or related notices sent to (list name di fax number and/or mailing address): • • I certify that the'iaformation contained in this notification and any supplemental information provided is, to the asdpleteness Review best of my knowledge, accurate and co plete. °'1`01 complete %� ❑ MX deficient - Business Name: l ift • i'. • Fax i%, 94'J/Phone: (51)Of* Mgr See Attached 0 Mailing Addr I 1 i1 tt�-i� La�Ce_,_ Signature• Print Name: `a.► ktJ Agency Ure Only 3 Spokane Clean Air, 1101 W. College, Suite 403, Spokane, WA 99201 / www.snokanecleanair.ore / Ph.: (509) 477-4727 Fax: (509) 477-6828014 „ntifirarinn n.rtvul will team when a completed NOI. includine required nonrefundable fees, is received by SRCAA. Not tome Clean la Agency Use Only Refer to the Agency's Renovation, Detinolition., and Asbestos Information Sheet as well as Regulation T Article IX A. Project Type: Q Asbestos Removal U Asbestos Removal & Demolidon Demolition, No Asbestos Removal Does this project involve a fire -damaged structure?:es U No (If yes, refer to Sections 9.03.F.3 and 9.08) Does this project involve more than 1 structure?: Yes$No (If yes, refer to Section 9.04A.3) Does this project involve denoolitiion by fire training?: 0 Yes 10 (See Sections 9.02.R, 9.03.F.4 & 9.04.A.6.f) B. Property Owner: iti t 7 -?%C Phone: -7,M-- (174Vax: - Pci /-00S Mailing Address: tge2e1 Ai, .S /.4.7 . . City: $... /(. (fa State: 6r/ rip: 9®/6 ' Zip: C. Site Address: l� ti. ■tom - , _ City: _N. . v . State: . ' Contact Person: Fowlk f `�+ c �-`cr r Iob Site Phone:A4 /- 0-0176 D. 0 Material Presumed or ,�..Mbestos Survey 1 If a survey was performed, was asbestos found? U Yes,No — AHERA Bldg. Inspector Name: 3 f ---F . Gula. 4- Company: t�-�L vj.rU k i' iv,Lt -1 Cert. No.: fb'9' Q rg a t, 14 E. Asbestos Removal Information: Start Date: Completion ' Date: Abatement By (if known): ' List individual type and , quantity of materials to be N I� removed. If >1 structure, list / types and quantities by address / location. Total Square Feet Total Linear Peet:, F. Demolition Information: Start� Date: F �I0 Completion / / Date: �f / / / ® Demolition By , r if known : ii L G. Asbestos Project and Demolition Notification Waiting Period and Non -Refundable Pee Categories Chviic'1'-91UIpir11. 111;2,1k -1 loi lencr is M. R(11010(1011, fern,,. S ANIJI5105 into. sheet) 1my- tr. A11 Demolition (all asbestos must be properly removed and disposed of prior to demolition) : W.lIti)1g Peii0i 3 Days Fee $30 Not ill1rivi -,I,cu11itd, siilok f.wiil} 1t,ilkitC( W,1Itiug I ilIf),1 CC( 2.0 10-2591n ft and/or 48-159 sq ft asbestos 3 Days $250 3. ❑ 260-999 In ft and/or 160-4,999 sq ft asbestos 10 Days $500 4.0 Z 1,000 In ft and/or z 5,000 sq ft asbestos 10 Days $1,250 _ 5. 0 All Demolition 10 Days 5250* ,'lltiit11m.41 c,lIc'orits Q I have completed and attached the Supplemental Notice of Intent (NOl) for emergency, alternate asbestos project work practices, demolition with nonfriable asbestos roofing, or exception for hazardous conditions. The $250 demolition fee is waived if demolition u performed in conjunction with asbestos project category 2.3 or 4, above. H. Optional: List additional parties you would like copies of this NOl and/or related notices sent to (list name di fax number and/or mailing address): • • I certify that the'iaformation contained in this notification and any supplemental information provided is, to the asdpleteness Review best of my knowledge, accurate and co plete. °'1`01 complete %� ❑ MX deficient - Business Name: l ift • i'. • Fax i%, 94'J/Phone: (51)Of* Mgr See Attached 0 Mailing Addr I 1 i1 tt�-i� La�Ce_,_ Signature• Print Name: `a.► ktJ Agency Ure Only 3 Spokane Clean Air, 1101 W. College, Suite 403, Spokane, WA 99201 / www.snokanecleanair.ore / Ph.: (509) 477-4727 Fax: (509) 477-6828014 „ntifirarinn n.rtvul will team when a completed NOI. includine required nonrefundable fees, is received by SRCAA. Not tome