2008, 06-06 Permit App: 08002157 Demolition GarageProject Number: 08002157 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/6/2008 Page 1 of 1
Project Information:
Permit Use: DEMO (1) DETACHED GARAGE (23 X 34)
Setbacks: Front
Site Information:
Left: Right: Rear:
Contact: GLASS, TIMOTHY S
Address: 1825 N PARK RD
C - S - Z: SPOKANE VALLEY, WA 99212-1548
Phone: (509) 251-5865
Group Name:
Project Name:
MERERIMSM74€ r,
Plat Key: 001760 Name: N P SHOPS ADD
District: Nort
Parcel Number: 35124.1901
SiteAddress: 1825 N PARK RD
Location:: CSV
Block: Lot:
Zoning: I-2 Light Industrial
Water District:
Area: 52,032 Sq Ft
Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Permits:
Contractor: OWNER
Item Description
DEMOLITION ACCESSORY
Notes: tix. Wit,:.: ..:.2.... ::
Payment Summary: .... A.`
Permit Type
Demolition Permit
Owner: Name: GLASS, TIMOTHY S
Address: 1825 N PARK RD
SPOKANE VALLEY, WA 99212-15
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Demolition Permit
Firm: OWNER
Phone:
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
(000) 000-0000
Fee Amount
$20.00
$20.00
<_ max _ ; ; ... , A-V.:m.4 .:. .._; Z:
Fee Amount Invoice Amount Amount Paid Amount Owing
$20.00 $20.00
$0.00 $20.00
$20.00 $20.00 $0.00 $20.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed By: jmm
Print Date: 6/6/2008
Permit Center
Sary oe 11703 E Sprague Ave, Suite B-3
pokane Spokane Valley, WA 99206
disValley. (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Community Development
Demolition
Permit Application
2(
PERMIT NUMBER: (.,',Y‘ - J
PERMIT FEE:
Commercial
Residential
r
SITE ADDRESS: A, 7,52S / 71-k_ J^d
ASSESSORS PARCEL NO: 351 (4.14 . /'8
Building Owner:
Name: //et4a' S 6`d ss
Name:
Address: d n LA Z Arx. %i•
City:sp e),Ue relit State: 1t). Zip
/al
Phone: c-99 c)5., 3 /5Fax:
City:
Contact Person
Name: -7 ti i S%, 4,X0 SS
Phone: SO9 — 07.5/ —
Describe the scop of work in detail
Contractor:
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Contractor Lic No:
Exp Date:
City Business Lic. No:
L1j//ye?, S P
wtik A site plan is provided.
o Spokane County Utilities has approved the disconnection.
o Notice of Intent #
The permittee verifies, acknowledges and agrees by their signature that: 1) Ownership of this City of Spokane Valley
Permit inure to the property owner. 2) The signatory is the property owner or has permission to represent the property
owner in this transaction. 3) All construction is to be done in full compliance with the City of Spokane Valley
Development Code. 4) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances.
Ownership of le• • eve • ment rights gr., me • • y any issued permit inure to the property owner.
Signature_ _ �,, k Date b V-- 08
Method of Payment:
[P, Cash
Bankcard #:
Authorized Signature:
REVISED 2/16/07
❑ Check
❑ MasterCard
❑ VISA
Expires: VIN#:
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SRCAA NOI No.
OS1101
0�P
Agency Use Only
SPOKANE REGIONAL CLEAN AIR AGENCY (SRCAA)
West College, Suite 403, Spokane, WA 99201
NOTICE OF INTENT (NOI)
For Asbestos Projects and Demolition Projects
U
-
DEte FCecetVed 13y ReAA
JUN 0 6 2008
SPOKANE cliMINAL
Alit AGENCY
L
`'
A. Project Type:
1. ❑ Asbestos Removal
2. ❑ Asbestos Removal & Demolition
3.A I:einoIaibn,
CLEAN
no Asbestos Removal
B. Property rr n /
Owner: //me- //me -A,/ S'. L= c t SS
�� o
Phone: AQ5`r5 6'�
(If available)
Fax:
Property Owner's
Mailing Address: Al, �j %jam rA Y�•
City: Sl (1,76,State:
�/"_I
GIJ
�
Zip: .2a
C. Site
Address: �, / 2 /� 14
r`
City: <! ,'
��////
State:Al
Zip: cf Z
Responsible Site � � l
Contact Person: ! ` ' n Y!/: �/, SC
Job Site _
Phone: ea 257-1R�(�
D. a Asbestos Surveyor If su�/e erformed, was asbestos found?
Y
❑ Material Presumed ❑ Yes 141 If "No" for any structure, attach survey
Date Survey/
Conducted:,' Zit
No. of Structures:
(see back if>1) 1
AHERA BuildingCertification
Inspector Name: Mal
r (G �,ial�j, k.
Number: 88 —' 2.6
Z
Exp.
Date: a 'S ?
E. Asbestos Project
Information:
No. of Structures:
(see back if>1)
Start
Date:
Completion
Date:
Wk. Days: Su M T W Th F Sa
Hours:
Total quantity
to be removed:
Ln.
Feet
Sq.
Feet
Will all asbestos material be ❑ Yes
removed by project completion? ❑ No
Will work schedule (J Yes
fax pgm. be used? ❑ No
List individual type and quantity of materials to
be removed or provide an attachment of same:
Abatement
Contractor:
Phone:
Fax:
Mailing
Address:
City:
State:
Zip:
F. Demolition
Information:
No. of Structures:
(see back if > 1) /
Start/❑
Date: -' 7 -kr,
Training Fire (List Fire Dept. as demo. contractor below)
❑ Ordered Demolition (attach copy of Order)
Demolition n
Contractor: /,,I4DZL 5e6 `Q SS
Phone: ca5I - 5865
Fax:
Mailing
Address: A,/,', a2. /o7/��r-IG I'ei)
City: ,Cie /1:44State:`(,V,
Zip: j?o2oA
G. Asbestos/Demolition Project Categories:
Notat'on
Waiting Period
Non -Refundable
Project Fee
Does this project involve a fire -damaged structure? ❑ Yes 0 No
1. U Owner -Occupied, Single -Family Residence Asbestos & Demolition Project *
(Owner -Occupied, Single -Family Residence Demolition Project *
Prior Notice
$30
2. (J All Other Demolitions With No Asbestos Removal Project
10 Days
$250
3. ❑ 10 - 259 linear feet or 48 - 159 square feet (see back of form for options)
3 Days
$250
4. ❑ 260 - 999 linear feet or 160 - 4,999 square feet
10 Days
$500
5. ❑ > 1,000 linear feet or > 5,000 square feet
10 Days
$1,250
6. ❑ Emergency Asbestos/Demolition Project (attach "owner's letter")
Prior Notice
Twice Project Fee
7. ❑ Altercate Means of Compliance for Friable Materials (attach plan)
10 Days
Twice Project Fee
8. 0 Alternate Means of Compliance for Nonfriable Materials (attach plan)
10 Days
Twice Project Fee
9. 0 Exception for Hazardous Conditions (attach plan)
Concurrent with Project
Regular Project Fee
10. U Demolition with Nonfriable Roofmg Left in Place
10 Days
Twice Project Fee
* The two categories in G.1 apply only to owner -occupied, single-family residences, which means any non -multiple unit bui ding containing living
space that is currently occupied (prior to and after renovation/demolition) by one family who owns the property as their domicile. One of the
categories must be used for all other asbestos/demolition projects. For more information, contact SRCAA at (509) 477-4727.
H. Optional: List dditional parties you would like copies of this NO1 and/or related notices sent to (list name & fax number and/or mailing address):
IV
I. I ertify t the information contained in this notification and any supplemental data provided is, to the best of
y o , edge, / urate nd o e
" uoz S, Goss C-5-- 9$
ompleteness Review
NOI complete
0 NOI deficient
See Attached
if: re presenting Date
For demolition projec s, this I expires 12 months from the earliest listed asbestos/demolition project start date.
` 1c_ r 1aaP
Agency Use Only
RCAA
Your advance notification period will begin when a completed NOI, including required fees, is received by S
._ _ .. . 1- _ _--_1_1.1_ r__ «.,._ ,.« ,.11 cf nirn -imp