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2001, 03-02 Permit App: 01001190 Demo ResidenceProject Number: 01001190 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 3/2/01 Page 1 of 1 Project Information: Permit Use: DEMOLITION OF RESIDENCE Contact: LARSON'S DEMOLITION Address: PO BOX 4535 C - S - Z SPOKANE, WA 99202 Setbacks: Front Left: Right: Rear: Phone: (509) 535-7944 Group Name: Site Information:Project Name: Plat Key: 000000 Nanie: UNKNOWN District: H Parcel Number: 35124.0903 Block: Lot: SiteAddress: 6714 E MONTGOMERY AVE SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: 43.561 Sq Ft Width. 0 Nbr of 13ldgs: 0 Nbr of Dwellings: 0 Review Information: Owner: Name: MUTUAL MATERIALS COMP Address: PO BOX 2009 BELLEVUE, WA 98009 - Hold ❑ Depth: 0 Right Of Way (ft): 0 Department Review BUILDING Special Inspections C4 A I Released By: Hold Reasons: Permit Conditions: _tl-o0)5 Permits: Demolition Permit Contractor: LARSON'S DEMOLITION INC Firm: LARSON'S DEMOLITION INC Address: 6505 E 9T1-1 AVE Phone: (509) 535-7944 SPOKANE, WA 99212 Item Description Units Unit Desc Fee Amount STATE SURCHARGE 1 Y OR.BLANK $4.50 DEMOLITION 750 SQ FEET $35.00 COUNTY SURCHARGE 1 Y OR BLANK $7.70 Payment Summary: Permit Total Fees: $47.20 Operator: DNB) Printed 13y: DMD Print Date: 3/2/01 Permit Type Fee Amount Invoice Amount Amount Paid Amount Owine Demolition Permit $47.20 $47.20 $0.00 $47 20 Notes: , $47.20 $47.20 $000 $47.20 lhl _N SromNECOUNUT PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: 4 7 /'I E ham,„t-[wfALV Assessor's Tax Parcel Number(s): Legal Description: Project Description: O Building Permit O Change in Use O Grading 0 Manufactured Home Permit O Relocation O Sign O Tenant (New/Change) Other iwnrxF.h'St e}. - _-n :” iA„"',i'Ti,-,`. j.';2^'::Ot t..'r '.'`3Y<''e:'«�:. :^*._ epartrrierit LJse`Oiily �:_,= , ��i��;r�. •�, . _ _ :a' _\z.. ^.f_:.iPV'L. _'t uu'•_R'.'.°.hl"'yse.t._y +W. atet65Disi4.;m4rii:c.•tt/P^ea'iiv.a:..3r_.<gi` : i.:. iv•'(�„.y_ oi.')-?if. aJ. .$7ac.qfifw,aD;<.: 67..srY,nr.Ect/P.f;d.a '•i.`"t. j'•iRo:.:ad.e:.-it_4vi:-..:fi..=>::s:::_'2".J.•µrt @hsoun:x '.'.tbr,a.$<."�i:� .fi!`,.t.•!t".."'.'��•a' ;t,bX�r:s`^wa;:!yy-'�^.5„:"��. ea�u rJr_...�Y>f! �z�_t',.w-"tsr'�,n y ' Ai .. rt. .S'3•i♦w:.e::....': �.f. So: U.o^rA.rDisa.s.ni.%.-::!..2r.;•u�.,,':.: + -;:+s.•-: :...'.,�«t: Y..::.;_=+.....o.;r:,..a,., ,smsF-• Ai.>ie•.D' ist,:.n-'r<._.atr-0 _. i.-�....._...2...L%h6�.': • .... .'.•.Zn o- ._._w:.. ,..a_..=... r»ra....,YL��:�«:�z`e� vo'',.'i • .s. [< ,-t:::'s' .._. «-.... OWNER/APPLICANT INFORMATION IA Indicate who should be contacted reeardrn? thzs nroiea 0 Owner: M Xy o �y phone: Sao X1202-.5/DG tY'',falur/Mt red/ A,S Fax. 0 Applicant Phone' Fax: Mailing Address: �7l err /n / di 2 ..�/e 'vr htaibng Address Unfinished basement sq. ft. City, Suie, Zip o Univ E WY/' Z/ v City, State, Zip 2"d floor sq. ft. 0 Commcor Phone .S-Y�( S-35--7 V$1 %.J4/ZSD4(/ S,%)fraz/Tivii Fax.. 5-35-36r7 0 Architect/Engineer Phone Fax Mailing address Ad. d. /j6 7 2/5 3S Mailing address Cost of pmlect City State Zip �aKif&C 634. CM2 -20 o <5 3S cry. sore Zip - WA State Contractor license X 4. ARS oD1 /6e/2&c- Contact nam.. PRO IECT INFORMATION .,,,—. —x: } "Jj' _ ".._"'u;-. •"s �,,y��< -e :: _ '. • v ; ..'a'`.?%*..`'' -e`."` �::TtTQY `,.:L.F2•_:<wv A:::s.-'r -£{,+'K4ii'n ,�.. y.i�h_'_.. -'S::rr.-iS '.�R iih'i `nU." La5': _ _ 'ry �,. wf Billldin Information*.r .tis --3 ,- - _ '-•.''IiFya:.t'n�i, �e: -^ i:'v.�+4 .'"nl.?n ':r'S`.'...:'i'i.14'.�P.Y=�.._ .,Ya. :i:` e�.. _e.f..:"..?`� ? rt!� �'_.-_,.._ .. z.• y,.�yn p:i•=.W i....i �i':S :e � �`niY. �:v`d}.S. f.'Y,}<L3 Building height to peak X of stories : / Main floor sq. ft S V Unfinished basement sq. ft. Dimensions a5x9d Total habitable space 2"d floor sq. ft. Finished basement sq. ft Occupancy group Construction type Garage sq ft. Deck sq. ft. Cost of pmlect bleat source (electric, gas, etc ) Vinurfalprdo�**i e =.> r a .?„„,-.:.7.4 •Yr i...a:'*<csyn.c;�r.^,v.r..eF What is the current use of this property?? BL[a$/A'FCS RESAaitICE, � Width: Length: What is the square footage of the sign face? How high is the sign? Year: Make: - N of signs Area of existing signs ''.>5='c"x .'?':`ti;v'•w,""✓ k:`SA' ° Itelooatlon ..f �_:..,a x ,� 1 .d,^ }.'!`i .,a�t� ,,a^... r5�,-�4.'n�L�ia'ac*fS.. rte.. _:t.�'ark.2�K'.v.:F'}:k`;T.a:r�:»^3C..�”:�S',J4%:vtini�:.,v._.....;otia':tK:wiw.y`?:�,,��h: :d y'<'ir .. <y0..",.'K?s w” .vE_`a,:• '>�y'•eaa''e:„ai::.i=r:'=:X-'7. fdf Ire;Safe J�4in �kW.'3°.'Sr.�c �lix`.4{,.i:.,.r�..r::_'s'e;�w:';,�`„^..�.,p'!::-r.S-N'ru'1:M1-� Previous address What is the current use of this property?? BL[a$/A'FCS RESAaitICE, Paint booth Fire Sprinkler Tent _ Fire Alarm Fireworks display Is there evidence of fill or excavation on the proper[ > O Yes $ No _ Proposed use Value SpecialIilspectfons Required' sy k,, NOn„.-„ esiaentialOrnergy Code Go"mgliance. rx :tel.; Finn Name What is the current use of this property?? BL[a$/A'FCS RESAaitICE, Phone Will the site be served by a septic sysssfffem? 0 Yes )RNo Plans Examiner Phone Inspectors- Is there evidence of fill or excavation on the proper[ > O Yes $ No Are there slopes greater than 30% on the property? 30 ft rise in 100 ft) (,--------"%) O Yes No Are critical or hazardous materials used or stored on site? 0 Yes 'No Address Inspector Phone 0 Concrete 0 Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? M Yes 0 No If yes, identf on site plan What is the current property size? vK�loevN (square feet or acres) Is any part of the property within 250 feet of a shoreline? I%yes, identf on site plan 0 Yes XNo What is the current use of this property?? BL[a$/A'FCS RESAaitICE, Is your property in a designated wildlife habitat area? 0 Don't know 0 Yes L (No Will the site be served by a septic sysssfffem? 0 Yes )RNo Is any part of the property within a 100 yr flood plain? If yes, identify on site plan 0 Maybe 0 Don't know 0 Yes No Are or will there be wells located on the property? If yes, identify on the site plan 0 Yes No Are there any wetlands, streams or ponds within 200 eet of the property? If yes, identify on site plan 0 Yes *No Is there evidence of fill or excavation on the proper[ > O Yes $ No Are there slopes greater than 30% on the property? 30 ft rise in 100 ft) (,--------"%) O Yes No Are critical or hazardous materials used or stored on site? 0 Yes 'No DEPARTMENT USE ONLY di, thepiopetlyom,ad stgnatedSc'oi` nwat �Gontirsea? ' e %'Is`pti6liesewer:avaslahle;[o`thestce? . rc. - O :Yesr-Q`;No _-- r^+.%{:�.-.••;w: x�Z Fi.- �;.• __ trOr :**i:7e...-s'--'� .r,.. ' aix'Sak.. .... tnvyPr �.J11}�S • s '`:Na. .0 . x-^a1�[5 !-d''aY�a axar� #Y"r#y.y�nr Yy. {si�¢i-44. i4 ",i �silr.•r.5.>�i':�:n=nnl�� YeS t�.:�+OSf,I�f04rW nmxa: ys:&!'{ zr"': ••: ' 'µ R1R'S?.*il'=SYK.s.Sa-ey"'...�...•Fh(3"r ITC e:pr6j ri 'i'nsId =[y�hyeiASig$:? =. __`?w',a' _"O Yest CIy N ?k; i1,,; %i k:t vi$a + M-- : •'.(.i'" vSmu4vw., `K:,.V' etb e,� '-,ik hv „`1'.", :>>'f7<_iCS 2C NO. t Y s24. Yry'-lsi sit p �"i=."i".L ..y>•.o�. ^.!,aY- tion''. j• �l£L 'a ?IS ptitiliErtet agailible.t0 the laic ;�4;s _''r=O=Yes O No: a .F: yez3'. ��=kY-`_. b--� w�.y�:'a-aA:.ly .Sw'•'+ „iW.vei, �} :Y=2t3'a v�:.ka4�iE..a-.^y-z:- "v -F�Noz suNhe'stxr=pFiope`isi deth,P.,`$SA ?:;et�.- :�-a:}=si0 YesyDP s��+flieiztirtr."r�a loeatiew'i[liin�000feer. 5fCN5atCualERs`i-A- F �"Staz:c jl'©?YesNok?�_'s;-, ea_H ..f V-E?+.�.S' mst Dam Received: Staff Representative: METHOD OF PAYMENT ' VISA ❑ CASH ❑ CHECK ❑ Man ❑ . NJCOVER FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: SUBTOTAL .TOTAL;FEE`s_� ; I PARdnTFAlE A_'�'`"y'•E' 1[niiEE 0fkaThI•ABIETOsPOLANEµ' ?S4.4cc oOirrYPeftMCCENTER;X' ...Y': `•si-s"_',, F =?:i JAN -25-01 01:0TPM FROM-SCAPCA T-980 P 01/02 F-818 Agency Coe No. y o f _ 00i (- Ansa" Use ash..1-112,1 COUNTY MR POLLUTION CONTROL AITORITY SPOKANE IH 1101 Was Cass, gidte 403, !porno, WA 99201 NOTICE OF INTENT TD PERFORM: ' t i ri J GYM 'Ra1ey Um OnlyA. Project Type: 1 i. 1:1 Asbestos Removal Asbestos Removal & demolition 1 3.0 Demolbon, Nu Asbestm Removal B. Property Phone' 509) 922-4100 West Me C , Property ,ropey Ones!Mailing Address 6721 E. Tied CdY: Spclane State: WA Zip: 99212 C. Asians= eaadaliMeafMn.Ni Wu N IWAtWaan eon Contractor Coatrncsar IRS Em al of Wallington, Inc. Owner/CEO: Robert steed s Mailing Address: : 12415 EastTrent Avenue Photo: (509) 927-7867 Cantracla lob No.: City: Sprue Store: WA Zip: 99216 Pax: (509) 928-3933 [ 5089 B. Rite Address: 67216. Trac City: Spans State: WA Zip: 99212 Projat Malaga or Coned Peroon: Cad Burnham Phone. (309) 927-7867 L El • Ashen= Barmy oar Ty .....: No. o[ Santurce 1 Date Surveyed wet Conducted: 12/9100 Was Asbestos Pound? ® Yes 171 It -No, Attach Swvaw_-____ Expiration Date 1/4/85 •Msu9 Al ERA Builth.. MMfM a Mgsamoetl antw51 MOISOV YiY/ LT Inspection Name: Kevin hicCe nk Va0✓zt*P wino_ inters/ 0oWiedasNc le•Rts F. DeclaBaea infornmese r _ No. of Structures: 1 Stint I)e!s 1/23/01 . _ Training Fire Last Fire Dept. as demohtlnn catt:acta below) Ordered Demolition (attach copy of Order) Desataltdse Mont s.ama.oaar.as,oteas.Mrorrarari 11,11.211210/1•1111/0•1912. Or ____ CeaatrMr: Intel's Qu>roWitp _ Phone: (309) 535-7944 C. Admit= Priem tegennotioa: No. ofSuite:ru : Goo bock if 1) 1 Start Date: 1/22/01 ,_Date Completion 1/22/01 Wk Days.111 T W Th. F Sa Su Hauls: 7.00 AM - 530 PM Total Quantity to be Removed: Uwe BR • ...::. P1. - 950 Will all asbestos material be removed by project cotltpletron7 Q9 • Yes No Thames - Insulauol' ■ Boileaumaee Ina Dtmt Ins, fl Pipe Ins, Other. Surface Met -l. $ PeepaooMng Paints Plaster I Textured Coatings *se. Mart1 Nolan Bd.(1 Cement Pipe 0Flooring Mat'1 1 !Roofing Niel Other tL 1 Asbasseuensinsthise 0 hied Ca Ass: Owns -Occupied Residential Asbestos Removal & Demolition Project Owner-0=MM Residential Dcnolitjrm Project No Asbestos Removal Nonfarm gp2Bre Waiting Patio' Prior Notice 10 Dave NON-RFFUNDABL6 525 5150 2. au Al Other Demolitions With No Asbestos Removal Project 3. 10.259Mew Beata 48 -159 square feet (see back of form for options) 3 Days CiY11547s 5150 (; 0 4 Z 260 - 999 lima tett or 160 - 4,999 seam li d 5 ow 1.000 - 9,999 ars feet re 5,000 - 49.999 $Gusto feet 10 pawn 5750 6. >10 000linos Bed a > 50,000 aerie feet 10 Days 51,500 7 Emergency Asbestos Protect or f 1 F.mageney Demolition Protect Prior Notice Twice Project Pee 8 Alternate Meas of Conti:thanes Bribable 0tatmals o Demolitions 10 -Day Review Period Concurrent with pnject Twice protect Fee Twice Project Fee 9 [.] Albano a Mans of Camphene fa notable asbestos mutesiais L 1 es an* lar do ... is aid .. assts.' saafia:eea, tool.aap.ort d.aare:s.d Mai., is as the nee Gray Cowin ems) Review ... _.. aae4 e ._ -- as am w slaw ay rhea niece sr ,►amidew when le tog.srll the Pet -Armed By: . / s . I lar i i 7/o, �_� �..�-`w� IRS Eatvicapna+ml of Washington. Inc. Jarman 1Z 21� %Namae Ap,easaaag tar 4pari' the Cab Mat 0f/Sant (68-] ON JAN -25-01 01:0TPA1 FROM-SCAPCA T -9B0 P 02/02 F-819 The Spokane Cowry Air PoDution Control Authatity (SCAPCA) is the local air pollution authority Car Spokane County. SCAPCA's Regulation 1. Article DC and Attiole X, Section 10.09, requires advance nah&aetion be submitted to SCAPCA, on in Authority approved form, for any aslastae project involving materials equal to or gitater in sire than 10 linear feet or 48 square feet and for tiny demolition project, regardless of aabeseor content, molting structures with a projected roof area greater than 1 20 square feet. Notices of Imam should be mailed or hand delivered to SCAPCA (address an restore lade) with the appropriate project fee. A SCAPCA represerltea.e wt review the notificattmL and if it is completed correctly, a copy oil be retuned by ulna to the mating eddre,s attend in box C and box J. The retuned copy will be your valid nottfioauon. /asbestos And dcmallpm Pleats iavilving materials_ and snores helm/ the oatficati=C thresholds listed above me stilt subject to a I other IVAtmemrgm_of SCAPCA Regulation I. Article DC end Article X Section 10 09. J. Demati4W(—esarrece-rmawriarrWalfirICUI NOTAINr`aOMr'NZL Casttrscect jaunt's DemolitionOwner/CEO: J.ffLanon A: ldediagte M) Hos 4535 Phone. (509) 535-7944 Comtrsetoe ° Job tt: 32y Spence Spate: WA lilt 99202 Far (509) 5054087 GUIDELINES FOR SUBMITTMG AN ASBESTOS/DEMOLITION NOTIFICATION Box A. gook the eppropriam project type. Box H. Enter the legal property owner information. Hes C. Enter the asbestos contractor and mailing address or other properly trained company or person performing the asbestos project Cmttaot the Wtubimguan State Dept. of Labor R Industria at OSHA for worker araming/certification requirements Bea D. Enter the project site edam, for the asbestos project or demolition. Include a designated project manager or contact Pa's Rex 1- Cheek aabeata Dovey Of materiel presumed If asbestos survey is checked, fill out all infotmaoon requested. Except as provided for in Article IX, Section 9.03, all demolition with et without an asbestos removal trout haw en asbestos survey performed by an AHERA Building Inspector. Demolition with no ashcan's discovered in the covey must submit a copy of the survey along with the notification. Asbestos removal projects orly way check the material presumed box if all material' are to be removed end disposed of as asbestos-oentaining materials in accordance with SCAPCA Regulation 1, Arbele IX and Article X, Section 10.09. Boa F. Enter the dosnolipon project mformuman. If the structure is to be used in a t aitwtg tire. list the fie department responsible for conducting the berm as the demolition contractor in box J. If the property owner has been ordered to perform a demolition by government official, suMtnit a copy of the order from the appropriate official Bea G. Enter all asbestos project information requested. All multiple etrmemtre asbestos project notifications must be eubntitted with a work plan including a map of the area, site address for each structure, type and amount of asbestos in each structure, and a detailed work schedule. Box H. Cheek one project categasy in boxes 11-6. The project fee include the demobtun fee. Asbestos removal projects and demolition with an asbestos removal atwlving leas than 10 linear fed ar 48 square feet may be filed as project category #3 An emergency asbestos projector demolition may be requested by checking the appropriate job WS category m boxes 12-6 and then c tic m>g We applieatee ennegency box in category 17. Emergency asbestos project notifications must be submuted with s letter tram the property owner explaining the necessity for the emergency. Emergency demolition notifications must be submitted with a letter from an authorized govemmeot official or a boensed Slractu al engineer doctimennng that the structure is ai nummeint danger of collapse. To request an alternative means of compliance for friable or nonrnable materials, check the appropriate job tae amgery in addition to the applicable box in eategeriee #8 and 119. A work plan must be sulmuttcd'oy an ■pprowiaely trained individual along with the not&eeaoa Box 1. Sigh the notification certifying dao accuracy and completeness of the information provided on the Cotes. Be J. Eimer demolition contactor trailing information (on back). Me8/atdry messgenggeg &e required fa changes that increase the project type, job size category, the types of asbestos materials to be removed end work schedule changes. No fee is required for work schedule changes if the contractor is pupating in the Agency work schedule Sx program. A Satan processing the is required for all other amendments For technical asaw4aooe, contact SCAPCA err 436-4727. Ned* at tern 06-160EM 2/90