2013, 09-05 Permit App: BLD-2013-1775 Demo Residencep04 13 03:17p
Rob's Demolition
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Community Development Department
Permit Center
11703, East Sprague Avenue, Suite B-3
Spokne Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spo kanevallev.orq
509-534-9404
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DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS: 912. M Mort ail- Rai
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME: .)( yak
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MAILING ADDRESS:
Crry: Spokane
stwtE: WA
Project #01X-9-00- 1176
R tZIPr: P2t.o?= n
CONTACT PERSON NAME: Jay Torgerson
PHONE: 534-2970
FAX: 534-9404
U D 2013
CELL:
-CONTRACTOR NAME: Rob's Demolition CSV PERMIT CENTER
MAILING ADDRESS:
cm: Spokane
534-2970
PHONE:
3810E Boone Ave #203 S U B
STATE: WA
nFV II
—�— z1P.99202T
FAX: 534-9404
CELL:
CONTRACTOR LICENSE No.: ROBSD1970RR
ExPIRES: 12)22/2013
CITY BUSINESS LICENSE NO.: 602343577
__,PROJECT DESCRIPTION (Please Provide Site Sketch)
�{t Site Plan Provided "Notice of Intent #
cgs Spokane County Utilities has approved the disconnection
Describe the scope of work in detail
pISCLAIMER
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 aty 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 i5 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 cr additional
information may be required to be submitted and subsequently approved before this application can be processed.
Signature (h., rx4 v— Date: l{�hi
Method of payment: D Cash
Bankcard #: r REDAC ED
Authorized Signature: >J/art1 rfcit-Y
D Check "isa 0 Mastercard
EXP. REDACTEQIN#: REDACTED
r This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN GS2014-030.
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
Sep 0413 03:17p Rob's Demolition
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509-534-9404 p.2
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Project #" �3 j776.
RECEIVED
SEP 0 5 2013
CSV PERMIT CENTER
SUB # ( ) REV. # 7-1
Sep 04 13 03:17p
Rob's Demolition
E-NOI (submit, pay online)
Back
E-NOI #2013-0332
509-534-9404
p.3
Title
Price
Asbestos removal performed by residing owner
$0.00
Demolition $30.00
$30.00 paid on 9/3/2013 4:40 pm
Prope
Information
Fire Damaged:
Owner:
Phone:
Fax:
Address:
Contact Name:
Job Phone:
Structures
No
Jim (Judean) Hobbs
208-773-4417
922 N Mamer Rd
Spokane, WA 99216
Rob Carper
993-1719
Project
RECEIVED
1,_? 0 5 2013
CSV PERMIT CENTER
SUB #
REV #
1. 922 N Mamer RD
» 90.00 Inft (Window glazing )
Nonfriable
» 90.00 Inft (Nonfriable Window Glazing)
Asbestos Information
Material Presumed: No
Inspector Name: Todd Lewis
Sep 04 13 03:17p Rob's Demolition
Survey Company:
Certificate Number:
Survey Date:
Asbestos Identified:
Mountain Consulting
BIR -12-085
7/15/2013
Yes
Disturbed/Non-Intact: Yes
Asbestos Removal: Yes
Nonfriable Removal: Yes
Start Date: 9/4/2013
Complete Date: 9/9/2013
Contactor: Jim (Judean Hobbs) -- the homeowner
Sob Number: 922 N Mamer
Contact: Cal Plunk with TSA Construction
Phone: 208-773-4417
Address:
Demolition Information
509-534-9404 p.4
Start Date:
Contactor:
Job Number:
Contact:
Phone:
Address:
9/9/2013
Rob's Demolition
922 N Mamer
Jay Torgerson
534-2970