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2009, 03-02 Permit App: 09000471 Demolition GarageFeb 27 09 10:22a kane RECEIVED 02/27/2009 10:11 5096880037 LARSONS DEMOLITION INC Community Development Demolition Permit Application Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevaIlev.org SV PERMIT ULMI .frN 15095358087 p2 PERMIT NUMBER: O° PERMIT FEE: Zi ❑ Commercial ❑x Residential SITE ADDRESS: 2324 N. Park Rd ASSESSORS PARCEL NO: Building Owner: _ Name: Carol Larson Address: P.O. Box 4535 Name: Tom Kalin Zip:99220 Phone: 535-7944 Fax: 535-8087 Contractor Lic No: Exp Date: r,ARSOflT1 ede1.T Address: p. 0. Box 1 02 City: Colbert State: WA Zip. 9921 a Phone: 2 3 8- 9 4 6 9 Fax. Same Contact Person Name: Jeff Larson Phone: 994-3995 Contractor: Larson' s Dpm(31 i t -i nn, Ting, _ Name: Carol Larson Address: P.O. Box 4535 City: Spokane State: WA Zip:99220 Phone: 535-7944 Fax: 535-8087 Contractor Lic No: Exp Date: r,ARSOflT1 ede1.T 12/31 /09 City Business Lic. No: 6 0 0 5 5 6 9 9 7 Describe the scope of work in detail Demolition/Pemova1 Snow Damaged (--;"(31" A site plan is provided. x) Spokane County Utilities has approved the disconnection. x Notice of Intent # 09-0081 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 resu}g develop Signature Method of Payment: ❑ Cash Bankcard #: Authorized Signature: ent ri :Check 011 ct- granted by any issued permit inure to the property owner. Date 2/26/2009 ❑ MasterCard C7'I Expires: ❑ VISA VIN#: Effective 10-28-07 Page 1 of 1 P:1Community Development\Forms\Building forms\Demolition Permit Application.doc RECEIVED 02/27/2009 10:11 5096880037 Feb 27 09 10:22a LARSONS DEMOLITION INC From: Rivers, Roger Date: 02/25/09 16:48:39 7o: 'Larsons' Cc: %oermitcenter@spokanevailey.org' Subject: RE: Derno Project 5V I-t.KM1 I t ur I ILrr 15095358087 P•3 Patze1of1 0 The collasped garage at 2324 N. Park Road that is scheduled for demolition IS NOT connected to county sewer. Therefore a sewer permit IS NOT REQUIRED. Roger Rivers Customer Service Representative, SPokane County Division of UtiNties From: Larsons [mailto:larsons@nwadv.com] Sent: Wednesday, February 25, 2009 3:38 PM To: Rivers, Roger Subject: Demo Project Hi Roger, We have a collapsed Garage located at 2324 N. Park Rd. in the Spokane Valley, WA_ I do not believe that there are any utilities connected to this project, but need you to check for sign off on my permit. Thanks Carol 2/26/2009 RECEIVED 02/27/2009 10:11 5096880037 ,Feb 27 09 10:23a LARSONS DEMOLITION INC `eb.21. 2009 9:19AM SPOKANE CLEAN AIR tic of Intent No. $pokaru Agency Use Only r CgrAirAtency NOTICE OF -INTENT IURASRES'1PRO.JI.( IS / DF.i1IOLITit7'i SV PERMIT CENTERFR 15095358087 p.4 No.8343 P. I Refer to the Agency's.Renovation, Demolition, and Asbestos Information Sheet as well as Repletion , rt c e A. Project j Typef ED Asbestos Removal ❑ Asbestos Removal & Demolition 1 Ila Demolition, No Asbestos Removal Docs this project involve a fire -damaged structure?: ❑ Yes ® No (If Yes, refer to Sections 9.03.F.3 and 9.08) Does this pro cot involve demolition by ffre training?: ❑ YesQ No (See Sections 9.02.R, 9.03.F.4 & 9.04.A.6.f) .How strttetures does this project involve?: 1 (If more than I structure, refer to Section 9.04.A,3) B. Property Owner; Mailing Address: Mr. Tom Kalin P.O. Box 102 Phone: 238-9469 Bays: 238-9469 C. Site Address: 2324 N. Park Rd. City:Colbert Contact Person; D. erso - D. ®. Asbestos Survey or Data survey performed: 2 / 2 0 / 09 U Material Presumed Was asbestos found? 11 Yes to No E. Asbestos Removal Start 'Completion Information: Date: Date: Last individual tyo and ran ' of materials to be removed. If >1 structure, list materials for each structure by address / location. I City: Spokane State:- W A Zip: 9 9 0 0 5 State: WA J Zip: 9 9 2 7 2 Job Site Phone: 994- 3 9 9 5 AHERABIdg,Inspector Name; Darin lJeitz Company: YTRS Env ironm Abatement By (if known): BIR -08-111 Total Square feet: Wilt all asbestos material be removed from the s ttvcfu:e() by project completion? Q Yes 0 No 1.1: Demoliti ( Information:I3/3 I Total Linear Feet: tan Start ftcmo1iontiBy , Date; fkaown) Larson s Demolition, Inc G. Asbestos Project and Dentotition Notification Waiting Period and Non -Refundable Fee Categories Owi,tr-ncIupicd, S►aglc-luniiiy residence (sec the Renoeaiion, Denis, & :5sbeytos iojo. sheen ]. ❑ All Demolition (all asbestos must be properly removed and disposed of prior to demolition) Not on-ncr-ocotpicd,singtc-f:+niily residence 2.0 10.259.1u ft and/or 48-159 sq ft asbestos 3. 0 260-9991n ft and/or 160-4,999 sq ft asbestos 4. 0 z 1,0001n ft and/or >- 5,000 sq ft asbestos 5• ® Demolition Addition - categoric. Wailing Period ['cc 3 Days . u'V,ti(iuti Pei int' 3 Days $30 Fre S250 10 Days 5500 10 Days I0 Days 31 250 5250* ® /have completed and attached the Supplemental Notice of Intent (NOL) for emergency, alternate asbestos project work practices, demolition file, or axcepfian for hazardous conditions. 1 • The 2250 demolition fee is waived f dernolition is performed in conjunction with asbestos prgject caregoly 2, 3 or�4, above. >«. ()alone: List additional parties you would Mee copies of this NOl and/or related noti ees sant to (list name & fax number and/or marling address): . I. 1 certify that the information contained in this notification and anysupplemental best of my knowledge, accurate and complete. npp emerttal tnfotmadon provided is, to the & ipl r cots Review — Or complete Business Name: Larson Is 'Demolition, Inp. 535-6087 Mailing Address .P.O. 9ox 45r Spokane, WA 99220 Sigaatnre: i 4,r.i'I •'�. 1-41 PrintName: Carol Larson / phone:535-7944 ❑ NOI deficient - See - ' axed., Agermy Use Only Spokane Clean Mr, 1101 W. College, Suite 403, Spokane, WA 99201 / www.snolkanecleanah•.org.f !M.: (509) 47.7-4127 Pax: (5091477-MR2R V.►,.....ui1..r. RECEIVED 02/2712009 10:11 5096880037 .Feb 27 09 10:23a LARSONS DEMOLITION INC Feb.27. 2009 9:19AM SPOKANE CLEAN AIR F Notice of IntantNo. i Spokane AgencyUse 041 ; Clean Air ,„,q SUPPLEMENTAL NO! FIOILAtitiI'1.t)iI1:U.T1:( IS'I)1 :"401.11 10 \ or AMENDMENT SUPPLEMENTAL NOTICE OF INTENT A.Idiliun:d c.tctiUriU IZc tc1',2I10' SV HEI -011 I t;tly I tKr r< 15095358087 P•5 •.No. 8348 2— Eli 2 6 2009 • 1'1 ar rt i7C1rl at VV.Iirm,g Pctiud Sc Ir-RCIUnc1 )I)lr i"(c 5_1Emergency 1 Section 9.04.A.6.h safely hazard, �'� � ensure continuous vital identified during the financial burden. I:cl.,:rencc Section 9.08.A 1 PriorN4Aee � utilities, or minimize asbestos survey. V.:I;tiug I'&1IlliI 10 days LT?wit* gularFee - ,r c d,rx property damage. : is.,.I.-r., .icial,le yeti Twice the Regular Fee' Adclitlmn:rl 7, 8. Selectthe-reason that best desexibesyour situation:• �',� Sudden, unexpected event that resulted in a public health or g.) The project must proceed immediately to protect equipment, • Asbestos -containing materials were encountered that were not • The :Lu; - tmust . oeeedto avoid im, i •.; an unreasonable rc.tegul It^1 Alienate Asbestos Project Work Practices ` Exception for Hazardous Conditions Section 9.01.0 10 days _ 12ogu1ay Fee Name of person that prepared the Alternate Work tan: Company he/she represents: Tiisltwr•cedifiedAHERAProjeot•DesignerNo_: His/her Certifiiedindnstrial'Hygienist CIH).number or Professional Additlnn.Il t', Ic, ;I fes Demolition with Nonfriable Asbestos•- otifin i 1' :(PB):liceaso'tanber: Section 9.013;B 1\ nlliut.Fciiutl ro days \'ur-Itrltlu11 4111 F 1 Twice the Regular Fee Natne of person that detertninedthat nonfiable asbestos roofing material could bo left in place per Section 9:08.B: Company he/she represents: His/hercartifier AF3TsitAProieet•DesiignerNo.: NOTICE OF INTENT AMENDMENT Amendment for Notice of Intent No.: I til tin rc! Section 9:04:B Site Address: )i'.I itinL t'crind \fir,-Rc'I•un4l141 1'.c .,Prior.Notice 1 am the person that submitted the original Notice of Intent and 1 authorize the porson/business 1i'stt d:to the right to amend that Notice of Intent and/or the most recent amendment on file for that. 'Notice otIntent-(Sect. 9.04.B.1') Authorization given to: By (Signature): Date: PrintNa ne: Etninose: Project Type Chanted... To: ❑Asbesfos.Retocoral fl Ash es tosRemoval•&.Demolition f=Demolition,No_Asbegos Rereovdi Increase is the job size category that increases the waiting period tutd/or fee. a. List additional types and quantities: b. Increases the total quantity ofmate.rials (indicate sq ft or in ft)...Ftom This increases the notification fee... From: $ To: $ Newa[atetial.typcs that don't change the notification waiting p eiiod and/or fee. .a. List new types and quantities: _ TO: is attached:' ; The difference of $ Asbestos project... Start dale changed from: Demolition... Start date changed from: tJ ,Placing a project on hold (or) [j Taking a project oft' hold Cj Canceling a notification (Sect. 9.04.B.1.d dt; 9.0433.2.b) 1 certify that the information contained in this notification and any suppleinental Mformation. provided is, to beat of my Ioiowledge, accurate and complete. Business Name: Lar -son's Demolition Inc Fax: 53 5-8087 Phonn535-7944 : /Bntldate c3lan ftoul: to' O Mailing Address: P.O. Box 45`• 6•okane WA 99220-0535 IM/ , ,� . ante: Carol Larson. Signature: the Amendment Review '© Complete ❑:Ae•Ffcicnt - See Attached Agency Ula only Spokane Clean Air, 13.01 W. College. Suite 403, Spokane, WA 992011 www snokane t>air Pk; (509)4W-4727 •Fax: (509) 4774828 You advance notification period will begin when a completed NOI, including required Tom -cls Bat g fees, is received by SRCAA. troy ams E AtAtka:had Sbarage Garaga N 2174 N. Park FYise NM 'ID BALE S _. m CD ry 0 0 I�) W 01 r 0o z r*m w 0 mm d 0 r_m o� z -` Z N nm N LE00889609