2010, 12-28 Permit App: 10004160 DemolitionSj6&
�
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B -3' -
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenterCa sookanevallev.orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS: 3102 N. Lily Rd.
ASSESSORS PARCEL NO..:
BUILDING OWNER NAME: Dallas Alcorn
MAILING ADDRESS: 3102 N. Lily Rd.
Crry: Spokane Valley STATE: WA ZIP: 99212
CONTACT PERSON NAME: Willie HOwe
PHONE: 509 979-6346 FAX: CELL:
CONTRACTOR NAME: Larson' s Demolition, Inc .
MAILING ADDRESS: PO Box 4535
Cmr: Spokane STATE: WA ZIP: 99220
PHONE: 509 535-7944 FAX: 509 535-8087 CELL: 509 994-3995
CONTRACTOR LICENSE No.: L AR S OD I 1 6 4 RU
EXPIRES: 12/31 2 01 1crr r BUSINESS LICENSE No.:6 0 0 5 5 6 9 9 7
PROJECT DESCRIPTION (Please Provide Site Sketch)
Site Plan Provided ❑ Notice of Intent #
Spokane County Utilities has approved the disconnection
Describe the scope of work in detail
Clean up of Fire Damaged Garage with removal
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 this 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 this 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 ap. val for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submi - . . nd subsequently approved before this application can be processed.
Signature/% � Date: AO 841
Method of payment: ❑ Cash Check
Bankcard #:
❑Visa ❑ Mastercard
EXP: VIN#:
Authorized Signature:
Effective October 28, 2007 Page 1 of 1
P:\Community Development\Forms\Building forms\Demolition Permit App.1.doc
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gional al
A : ncyWeon Clean /#Iran , ..•
NOTICE OF INTENT
I ON ;1JItt:.s I"(.i$ l'1U).l(( 1 ti ! IiF;:11Of.il7U-\'
Ivo. 7/LY r.
From:Mary McDermott
C•I 1/ C
SPe�t�u:p I'S.' -�� A;Ori!
=C 2.7 2010..
Refer to the A enc s Renovation Demolition and Asbestos Information Sheet•as we as; , u anion i,;Article TX
A. Project Type: •❑.Asbestos Removal . -❑ Asbestos Removal D.emoIhtion. ' El
Demolition, ❑ Aemoli�on,lVo:Asiestos Remove -
Does this project involve a fire -dame ed structure?: t
� {�] =Y'es 0 No � crier, rnfei to'Sisciiptis �9.t13.P:3-and•9:g8-j
Does this pro'eJ ct involve *me !fis 9n -by -ft btraimng?.. • ..:.-..t] Yes jIl No' •• (Spe Sections 9.02=8, 9.03.P.4 &•9.04.A.6_ '
- •;H�w-map coiitt ''. ..- .. - '
y guuus'atrgotitres:does't 'ls.liroject involve? (5
(If more than 1' structure, -refer to Sectilari 9.04.A.3)
II: Property Owner:
Mailing Address:
C. Site Add ass: •
Dallas Alcorn
Contact'Person: •
3102 N. i,>.! 113. •. City: mule 11411 y ,State; .:�: Zip:•
"Wa] J i)a; tix+(e:": ` : ` Job Site Phone: 509 979-6.346
. ( Asbestos Survey'°fir• - Date survey performed:1 12/08 2010
..0nte
tial •Presumed Whs dsbtssto•
• s' ' - [ i es'®No
• fbundl Restaratim
JA 4,Dld pectQrdJame:.U4.1e•?kWe .
Company: Aeltit�
PXCrertY Cen, No.:
E. Asbestos Removal r Start
Information Date;
List••individuat type a4id
1 ABantibC of materials'le be' °
.removed, If>1 structure; list
materials foreach'structure •
by,address. /. location.
F; Demolition
Information:
Ggmpletion::: , • :>•• ::;,• ' ,•Atiateiilent By •,
Date:: ; Iciiowii):
Tt-10,005
•
Start
Date::.:
(earliest)
•
1
• .ITotal Linear l~ cet:• -i . ' •,• _ • • rTdial S aye Feer:
Will all asbestos material be removed from the structure(s) by project con letion7 Yes .,...„.3
No
1/03/201¢.:•. Dernolitionly I. , .
(if known): , •: • Tam- s `1[13tol t3:cri Try.
G . Asbestos Projectaad Demolltion•Nottfteation.WattingPeriod•and•Non Refundable Fee Cat
Your advance notification period will begin when a completed NOl. inctudiri r uired • --' • 1? f.
• _ .. _ $ eq J14n�,p�ablefbes,;s•recaivedbySRt:AA,
O'cncr-occupied, Si,i&e-inmily residence (c.c., the RenLltiun, C)cmu,, & ,‘shestns info. sheet) W;litiur; Period
1. ❑ a 10 !nil arid/.or� 48:so.fkasbestoi.kecrnocperfdimedWfc"s,ding-owner
All Demolition (all asbestos must be properly removed and disposed of prior to demolition) 3 Days
Not tmnrr-occul,ie(t, single-family residence
Prior Notice
3. (-J I0.259 in ft and/or 48-159 sq ft asbestos
4. D. 260-999 In ft and/or .1.60-4,999 sq ft asbestos
'S• ❑ k 1,000 In ft and/or> 5,000 sq ft asbestos
;6.0 All Demolition
Fee
50
Waiting f'criu(ll
3 Days
• '$30
Iee
$250
10 Days
5500
10 Days
51,250
. 10 -Days: $250*
* The 5250 demolitionfee-/s waived ifdemolition-is'perfoni:ed in conjunction wiih asbestos p oject emego;,y 3, 4 or S, above:
Additional Categories Which May Apply•to •the Projeet'Categories in 1-6, Above
Emergency Notification
7, 0 Emergency
Reference
.Section 9.04.A.631 •
Select the reason that hest describes your situation: •
Sudden;'unexpected event that resulted in a public health or.safety hazard.
a❑ The project must proceed immediately to protect equipment, ensure,eontinuous:vital utilities, or minimize property, damage:
Asbestos -containing materials'were encountered -that were not identified during the asbestos.survey,
The •ro'ect must •roceedto avoid imosin an unreasonable financial burden.
1Vaitiu� Pc) iod
Prior Notice
Nun-,kelun(lahli Ic,
Twice the Regularl"ee
,11(crnatc Asbc;tos Project N'urfc Practices
Reference Waiting Pet 'iutl Nuti-RefuntiahPe I -pc
Spokane Clean Air. 3104 E. Augusta Ave., Spokane,WA 99207 / xviymAaaggieeleaiight.argi Ph:(509)477..4727 ax'(309) 477-6828 >:•0W09 '
rvC6. L0. LVIV IV.LYtIYI JfVAHIYC 1,LCAIY HI(t
No. /29 I'•
Exception for lta7arduns Conditions.
days Twice the Regu
ftecceencc \1';titin,? Period Nun -Refundable 1;te
Com • airy he/she resents:' .
• j isiilrer.certif' ed: AHERA Project Dari'. 'ei Nb.:'
.His/her• Garr jified lnduattial-Hygienist (CJH)�number or '
Profeisiinal > ogineex (PE) licpnso number:
llcmolitirm iiitli Nurrfri:t to ASIIe.,tos Roofing
'10. Q IJemolition with Nonftlable Asbestos Roofing
Name of person that determined that•nunfriablo asbestos
• roofit material could be left in place poi Sect: 9.08.$:.
- • .Company he/she .represents:. • . • ,..
His/her celled AHERA"Pro act Deal 'or,
' •
)S. OprionahLlst additional parties you•would
I, Acknowledgement
of this NOl and/or related notices sent to (list nante dr,4a number and/ormef ing addmss)
• The Control Officer, orduly authorized representative, shall be allowed to access property at reasonable urges to inspect projects. .
' specific. to the control, recovery, or release of eontatriinents into the atmosphere, in accordance with SRCAA ttegulation 1, Article it •
• and RCW 70.94.200. For the purposes of renovation, demolition, and asbestos projects, reasonable times include; but are not limited
to, any of the following: when renovation, demolition, or asblistos removal appear to be occurring.or are schcdulgd.to occur, and times
when the Control Officer or duly authorized representative are investigating air quality complaints filed with. agency and/or have•
reason to believe that air "quality: violations have occurred or may be occurring. No person shall obstruct, hamper or interfere with any .
such inspection'.•
:, . .
•
' • 1 certify •ihaf the information contained in this notification and any supplemental information provided is, to the best of my knowledge,
accurate and complete.
Business Name: lawn
Mailing Address: EO �c «' nt -
Slgnatpr'e ='' MINIFA/1
Or. in
Lien,. Dr .%
•
4535
' Agency Use Only.
U NOT Dei icient:
*99
t• ,
Neino:
. - ' Photi: 509.535-7944
tt~tur .iris} �� r . LL�o. ^ ,Or.)
Receipt: 3311 12/27/2010
Acct N: 424 COPY
Spokane Regional Clean Air Agency
3104 E Augusta Ave '
Spokane, WA 9920? 5364
•
Larsons Demolition Inc .
PO Box 4535
Spokane, WA 99220-0535
4: ' Treasurer's Receipts
Nemo NO1 N10-0174
NO1 1110-0174
1� NOI Complete
Inrush
Non Taxed Amt:
Total:
47 A'5 Chk: 21593
Ttl Tendered:
Change:
30.00
30.00
30.00
30.00
30.00
0.00
Spokane Clean Air, 3104 E. Augusta Ave,,, Spokane,. WA 99207 / www.spokanecleaarg • Ant Due:
issued By: Nary
12/27/2010 16:10:54
0.00
Garage
Drive
Slab
3102
House
Lily Rd
rage 1 of 1
Larsons
From: "Rivers, Roger" <RRivers@spokanecounty.org>
To: "'Larsons"' <larsons@nwadv.com>
Cc:<permitcenter@spokanevalley.org>
Sent: Tuesday, December 28, 2010 12:22 PM
Subject: RE: Garage Demo/Fire project 3102 N. Lily in the Spokane Valley
The garage that is scheduled for demolition at 3102 N. Lilly IS NOT CONNECTED to the Spokane County
Sewer System. Therefore, a sewer abandonment permit and a sewer abandonment inspection from the
Spokane County Division IS NOT REQUIRED.
Roger Rivers
Customer Service Representative
From: Larsons [mailto:larsons@nwadv.com]
Sent: Wednesday, December 22, 2010 3:29 PM
To: Rivers, Roger
Subject: Garage Demo/Fire project 3102 N. Lily in the Spokane Valley
Roger, First have a great Holiday and wishing you a Happy New Year. We need the ok from
you for the demolition of a garage located at the above address. I do not believe that there is any
sewer connection, but it is in the Spokane Valley and needed for permit purposes.
Thanks Carol Larson
No virus found in this message.
Checked by AVG - www.avg.com
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12/28/2010
Jodi Main
From: Rivers, Roger [RRivers@spokanecounty.org]
Sent: Tuesday, December 28, 2010 12:22 PM
To: 'Larsons'
Cc: Permit Center
Subject: RE: Garage Demo/Fire project 3102 N. Lily in the Spokane Valley
The garage that is scheduled for demolition at 3102 N. Lilly IS NOT CONNECTED to the Spokane County Sewer System.
Therefore, a sewer abandonment permit and a sewer abandonment inspection from the Spokane County Division IS
NOT REQUIRED.
Roger Rivers
Customer Service Representative
From: Larsons fmailto:Iarsons@@nwadv.coml
Sent: Wednesday, December 22, 2010 3:29 PM
To: Rivers, Roger
Subject: Garage Demo/Fire project 3102 N. Lily in the Spokane Valley
Roger, First have a great Holiday and wishing you a Happy New Year. We need the ok from you for the
demolition of a garage located at the above address. I do not believe that there is any sewer connection, but it is
in the Spokane Valley and needed for permit purposes.
Thanks Carol Larson
1