2008, 10-09 Permit App: 08004014 Demo Garage Permit Center
Sp ���
c'r7 of0ne 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER:
Spokane Valley,WA 99206 J
Valley (509)688-0036 FAX: (509)688-0037 PERMIT FEE: c t Lj'—
www.spokanevalley.org
Community Development
Demolition Commercial
Permit Application Residential
SITE ADDRESS: /cqs (o 5a./Mc" /fit,e r LI4 e- /
ASSESSORS PARCEL NO: c-i--7. ;3 j . .�, 1
I (04 :')/ 5
Building Owner: Contractor:
•
Name:
Name: l L71, r 2 (C.1iit/.(.),
p;5.^s 4.Y /�s, •
Address: ,-,., � Address:
1 (O t
/ . - S(� M
( , ✓t r" tt/VY � `O IOC 3C (7
City: State: Zip: City: State: Zip:
Phone• Fax. P ne•� / Fax:
.� ,
Contractgr Lic No: Exp`Date:
x--C4. 'J Li 7 l oAcvio 9
Contact Person v� City Business Lic.No:
Name: 6,- F j tr�-J
Phone: ( ii' ) (,C,C> -:�76>w
Describe the scope of work in detail / / / /
�c4-4:, 1c.,--,iz ,►C3y"f ?c a:r le,--e.( 2 , � m.. C4arrP0 �l,Ns rrl 5..�t4 (,✓a/
o 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 resulting development rights granted by any issued permit inure to th property owner.
-'
Signature�,'` /_ /_.rre4,,,,,7Date /G 9 g6
Method of Payment:
❑ Cash heck ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
Effective 10-28-07
Page 1 of 1
P:\Community Development\Forms\Building forms\Demolition Permit Application.doc
•
E lr
ry, "' °.ir NOTICE OF INTENT OCT o 8 200$ .�
Notice of Intent No. ' Spokane- i;
•
•
Regional 4R1' FOR ASBESTOS PROJECTS/DEMOLITION rVKr+rv�n�uiulvML
Agency Use Only Clean ' `irAgency DDLEA ld IRAG6tik Only _
�.
Refer to the Agency's Renovation,Demolition, and Asbestos Information Sheet as wel s Regulation I,Article IX
I
❑ Asbe os Removal&Demolition I Demolition,No Asbestos Removal
A. Project Type: i ❑ Asbestos Removal I
Does this project involve a fire-damaged structure?: lJ Ye�s El No (If yes,refer to Sections 9.03.F.3 and 9.08)
N!d'N�yes,refer to Section 9.04.A.3)
Does this project involve more than 1 structure.: ❑Yes o (
Does this project involve demolition by fire training?: ❑/Yes No (See Sections 9.02.R,9.03.F.4 &9.04.A.6.f)
-y/ Phone:(?c. 57- 71 c4 0 Fax:
B. Property Owner: �.v✓a, ��,S/-, � I'',6 7<
Mailing Address: jg o(o /`/ S0,/,,t-7or' /2,ver' Ln City: 6—r-t en c rC 5 State:l,)f} I Zip:?90/CO
C. Site Address: /�2(P / ,/i/ sa(mon �,vr.r Ln. 1 City: =rr;en /9'Lr<LS State:l vlf I Zip: 996/
Contact Person: n Urn Job Site Phon‘z. )6 Ce/-G 7l et
D. ❑ Material Presumed or Asbestos Survey I If a survey was performed,was asbestos found? U Yes I: No / C I
.r.S I Cert.No.: o2S c, I
AHERA Bldg.Inspector Name: Pa v �,�-c,y�1,/t I Company: /
E. Asbestos Removal Start [Completion Abatement By
Information: Date: 1Date: (if known):
List individual type and
quantity of materials to be
removed, If>1 structure,list
types and quantities by Total Linear Feet:
address/location. Total Square Feet: I
F. Demolition Start Completion Demolition By
Information: Date:/0,a E (Date: l/Completion/
(if known):
G. Asbestos Project and Demolition Notification Waiting Period and Non-Refundable Fee Categories
Owner-occupied,single-family residence(see the Renovation,Demo.,&Asbestos info.sheet) Waiting Period Fee
1. 0 All Demolition(all asbestos must be properly removed and disposed of prior to demolition) 3 Days $30
Not owner-occupied,single-family residence
Waiting Period Fee
3 Days $250
2. ❑ 10-259 ln ft and/or 48-159 sq ft asbestos
10 Days $500
3. ❑ 260-999 In ft and/or 160-4,999 sq ft asbestos
10 Days $1,250
4. El > 1,000 ln ft and/or>_5,000 sq ft asbestos
j 10 Days $250*
5. 0 All Demolition
Additional categories
❑ I have completed and attached the Supplemental Notice of Intent(NOI)for emergency, alternate asbestos project work practices,
demolition with nonfriable asbestos roofing,or exception for hazardous conditions.
ory
* The$250 demolition fee is waived if demolition is performed in conjunctionwith easbestos
es oto( list name teject ganumber, 3o and/omailing address):
e.
H. Optional: List additional parties you would like copies of this NOI and/or related
I. I certify that the information contained in this notification and any supplemental information provided is,to the Completeness Review�' C3 NOI complete
❑ NOI deficient-
�
best of my knowledge,accurate and complete. / \
_f r,�rciv 14a)d: 2C 7.22=6 asr Phone: •7 7� (./ See Attached
Business Name: Klr'�5 �t'•�''` //
Mailing Address: m� e
2r C3 GZ !70_ Cie,v? j
-/� Print Name:
✓/� Agency Use Only
Signature: • - -
1101 W. College, Suite 403,Spokane,WA 99201 /www spol(a-1 eanaefi d Pe feesh.: .is received by SRC)477-4727 Fax: 509)NO! 10/08
CnnkanP.Clean Air, g ,_.-A wr�r :...,.1...1:.,
Oct 08 2008 11 : 21RM SPOKRNE#COUNTY#UTILITIES 4777178
P• 2
October 08,2008
To Whom It May Concern:
It has come to our attention that due to a reoenn of fire�the
metesscheduled for dem 1 on.
ome located.at 1826 N.
Salmon River,parcel #55083.2301,a pow of
The portion to be demolished will not affect the sewer a sewer bandion ntthe home
see
the
attached sewer connection drawing.) Therefore
Permit and inspection by the Spokane County Division of Utilities IS NOT REQUIRED.D•
If you have any questions,please call me at 477-7682.
Rog Rivers� � Division of Utilities
Customer Service Representative, Spokane County
Oct 08 2008 11 : 21RM SPOKRNE#COUNTY#UTILITIES 4777178 p. 3a1 �e ���y�
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3UBDIVISICN Ul_l.D. : NO DRY 0 ER - SEWAGE CONTAINER(S) ABANDONED 4 ❑'+'� ONO 12 N/A H.D. TILE EXTENSOR C.�
❑ p VTR at 0 CONTRACTOR 0 OTHERS
APPROVED EXTERIOR CONNECTION 1 YES ❑NO BY: NOTE: DIVISION BUILDINGS INSPECTS ALL INSIDE PLUMBING.
INTERIOR PWfBLDG. CHANGES 4 W CONNECTED TO SUBSTANDARD PIPET 0 �E` 0
COMMERICAL BLDG.:p NEw❑ RESIDENTIAL BLDG :0 NEW ORRANGESBURG
SEE ATTACHED HOLD HARMLESS AGREEMENT ❑
EASEMENT AGREEMENT REWIRED? ❑� .,, "•� L'
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