The URL can be used to link to this page

2010, 05-04 Permit App: 10001262 Demo Residence Community Development Department (Staff Use Only) Permit Center _ r�I 1� Sawokane0111111#.1\ 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER: I D I L l!� Spokane Valley, WA 99206 �O Valley Tel: (509) 688-0036 PERMIT FEE: Lel) 9 Fax: (509) 688-0037 permitcenter@spokanevallev.orq DEMOLITION PERMIT APPLICATION PROJECT ADDRESS: A/3 7/ .Sar. i9'€/(27--- ASSESSORS ASSESSORS PARCEL NO.: 3 kcZ"tie— (/Jl//e �f e.-c) /- BUILDING OWNER NAME: ` ' / MAILING ADDRESS: .. /.ji 3 ci,K <�-'t✓W/ /� CITY: S Ira ✓4 /l-e7' STATE: WA-- ZIP: c7 Z 4Z CONTACT PERSON NAME: / ni A1'!f r.S PHONE: 12 6. 3,Z 3 3 Fax: -- CELL: CONTRACTOR NAME: 7� MAILING ADDRESS: Al 2 Z/ 5joc/Z�y e6c// CITY: 5/ :),C,/) e Ati-e_ Y/4 //Ze'Ji STATE: tx..1/4^ ZIP: PHONE: g , 63-z 3 3 FAX: CELL: CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: PROJECT DESCRIPTION (Please Provide Site Sketch) /�� — Site Plan Provided ❑ Notice of Intent # i�PkAL Spokane County Utilities has approved the disconnection / Describe the scope of work in detail 4-1 `e! Sl9 /D — DISCLAIMER 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 City 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 is 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 or additional information may be required to be submitted and subsequently approved before this application can be processed. ��/ Signature �� Dater ' i - /o Method of payment: ❑ Cash D'Crieck ['Visa ❑ Mastercard Bankcard #: EXP: VIN#: Authorized Signature: Effective October 28, 2007 Page 1 of 1 P:\Community Development\Forms\Building forms\Demolition Permit App.1.doc Jodi Main From: Halsey, Lance [LHalsey@spokanecounty.org] Sent: Tuesday, May 04, 201Q 3:54 PM To: Jodi Main Subject: 311 N Sargent Hi-Jodi 311 N Sargent has been cleared for Demo from Health-Tom Nilles will be in to get the permit-Thanks, Lance. 1 2010-0068 NOTICE OF INTENT 4/14/2010 Notice of Intent No. Spokane �1 Agency Use Only Crean Airs , FOR ASBESTOS PROJECTS/DEMOLITION Date Stamp-Agency Use Only Refer to the Agency's Renovation,Demolition,and Asbestos Information Sheet as well as Regulation I,Article IX A. Project Type: ® Asbestos Removal I ❑ Asbestos Removal&Demolition 0 Demolition,No Asbestos Removal Does this project involve a fire-damaged structure? ❑ Yes ❑k No (If yes,refer to Sections 9.03,F.3 and 9.08 Does this project involve demolition by fire training? ❑ Yes 0 No See Sections 9.02.R, 9.03.F.4&9.04.A.6.f) How many structures does this project involve: 1 (If more than 1 structure,refer to Section 9.04.A.3) B. Property Owner: Tim Nillis Phone: 509-926-3233 FAX: Mailing Address: 211 N.Sargent City: Spokane Va State: Zip: 99212 C. Site Address: 311 N Sargent City: Spokane Valley Zip: Contact Person: John Graves Job Site Phone: 509-998-0483 D. 0 Asbestos Survey or Date Survey performed: 4/9/2010 AHERA Bldg.Inspector Name: John E.Graves 0 Materials Presumed Was asbestos found? ❑X Yes ❑ No Company:AHERA Cert.No.: BIR-09-065 E. Asbestos Removal Start 4/26/2010 Completion 4/26/2010 Abatement By Specialty Environmental Information: Date: Date: (if known): List individual type and 80 sqft GWB, quantity of materials to be removed. If> 1 structure,list materials for each structure Total Square Feet: 80 Total Linear Feet: 0 by address/location. Will all asbestos material be removed from the structure(s)by project completion? ❑X Yes ❑ No F. Demolition Start Date Demolition By Information: (earliest): (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 >=10 In ft and/or>=48 sq ft asbestos project not performed by residing owner Prior Notice $0 2. ❑ 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. ❑X 10-259 lnft and/or 48- 159 sq ft asbestos 3 Days $250 4. ❑ 260-999 lnft and/or 160-4,999 sq ft asbestos 10 Days $500 5. 0 >1,000 In ft and/or 5,000 sq ft asbestos 10 Days $1,250 6. ❑ All Demolition 10 Days $250* Additional categories *The$250 demolition fee is waived if demolition is performed in conjunction with asbestos project category 2, 3, or 4 above. Additional Categories Which May Apply to the Project Categories in 1-6 Above. Emergency Notification Reference Waiting Period Non-Refundable Fee 7. ❑ Emergency Section 9.04.A.6.h Prior Notice Twice the Regular Fee Select the reason that best describes your situtation: ❑ Sudden,unexpected event that resulted in a public health or safety hazard. ❑ The project must proceed immediately to protect equipment,ensure continuous vital utilities,or minimize property damage. ❑ Asbestos-containing materials were encountered that were not identified during the asbestos survey. ❑ The project must proceed to avoid imposing an unreasonable financial burden. Alternate Asbestos Project Work Practices - Reference Waiting Period Non-Refundable Fee 8. 0 Alternate Asbestos Project Work Practices Section 9.08.A 10 days Twice the Regular Fee Exception for Hazardous Conditions Reference Waiting Period Non-Refundable Fee 9. 0 Exception for Hazardous Conditions Section 9.08.0 10 days Regular Fee Alternate Asbestos Project Work Practices Company he/She represents: I His/her certified AHERA Project Designer No.: His/her Certified Industrial Hygenist(CIH)number or Professional Engineer(PE)license number: Demolition with Nonfriable Asbestos Roofing Reference Waiting Period Non-Refundable Fee 10.❑Demolition with Nonfriable Asbestos Roofing Section 9.08.B 10 days Twice the Regular Fee Name of person that determined that nonfriable asbestos roofing material could be left in place per Company he/She represents: His/her certified AHERA Project Designer No.: H. Optional:List additional parties you would like copies of this NOI and/or related notices sent to(list name&fax number and/or address:) Acknowledgement The Control Officer,or duly authorized representative,shall be allowed to access property at reasonable times to inspect projects specific to the control,recovery,or release of contaminants into the atmosphere,in accordance with SRCAA Regulation I,Article II and RCW 70.94.200.For the purposes of renovation,demolition,and asbestos projects,reasonable times include,but are not limited to,any of the following:when renovation,demolition,or asbestos removal appear to be occurring or are scheduled to occur,and times when the Control Officer or duly authorized representative are investigating air quality complaints filed with agency and/or have reason to believe that air quality violations have occurred or may be occurring.No person shall obstruct,hamper or interfere with any such inspection. I certify that the information contained in this notification and any supplemental information provided is,to the best of my knowledge,accurate and complete. Business Name: Specialty Environmental Phone: 509-535-1313 Mailing Address:2626 E. Trent Ave. , Spokane,WA 99202 Signature: Date: J. Agency Use Only: El NOI Deficient: _ Rec #: 2148 Inv it: 2147 0471572010------- Acct #:#: 1244 Spokane Regional Clean Air Agency — 3104 E Augusta Ave — Spokane, WA 99207 5384 Speciality Environmental — 2626 E. Trent Ave Spokane, WA 99202 — Treasurer's Receipts _ Memo 2010-0068 311 N SARGENT 2010-0068 311 N SARGENT 250.00 — Non Taxed Amt: 250.00 — �� NOI Complete `fr/S-0 Total: 250.00 Date&Initial Chk: 20100068 250.00 Ttl Tendered: 250.00 Change: 0.00 Spokane Clean Air,3104 E.Augusta Ave.,Spokane,WA 99207/www.spokanecleanair.org/ Ph:(509)477-4727 Fax:477-6828 09/09 • _ t I E �R F F r a26/6 NOI AMENDMENT z F t1 Notice of Intent No. Spokane {' �> _' FOR \S3IS1OS PROJECTS/ )1 \IUIIIIOV Regional iA Agency Use Only Glean Ar Date Stamm Agency.Ilse t) i • =r NOTICE OF INTENT AMENDMENT Reference Waiting,Period Non-Refundable Fee Section 9.04.B Prior Notice $0 Amendment for Notice of Intent No.: 2 )jCJ C" Y Site Address: 3 f1-��,�� V°' - 'A)k” I/my company submitted the original Notice of -—� ` y ' J Intent and I/we authorize the person/business o m )i`l�A c� ( ) rvv 'T 11 ��1. listed to the right to amend that Notice of Intent List the Name of the Person or Bu ess that You're Releasing the Notification To and/or,if applicable,the most recent amendment 2. x 9 LG;.. 33 on file for that Notice of Intent(Sect. 9.04.B.1). Their Address Their Telephone No. Project Type Changed...To: ❑Asbestos Removal ❑Asbestos Removal&Demolition Cl Demolition,No Asbestos Removal Changes that increase the notification waiting period or fee(e.g.,additional quantities of asbestos or change in the category type). . a. List additional types and quantities: b. Increases the total quantity of materials(indicate sq ft or In ft)...From: To: c. Category Type Changed...To: ❑Emergency ❑Alternate Asbestos Project Work Practices ❑Exception for Hazardous Conditions ❑Demolition with Nonfriable Asbestos Roofing This increases the notification fee...From: $ To: $ ;The difference of$ is attached. New material types that don't change the notification waiting period and/or fee. a. List new types and quantities: Asbestos project...Start date changed from: to: /End date changed from: to: Demolition...Start date changed from: 'j 1► to: 5 1"(0 ❑ Placing a project on hold (or) ❑Taking a project off hold(List new start date and/or end date,above,if applicable) ❑ Canceling a notification(Sect. 9.04.B.1.d&9.04.B.2.b) Other: Acknowledgement The Control Officer,or duly authorized representative,shall be allowed to access property at reasonable times to inspect projects specific to the control,recovery,or release of contaminants into the atmosphere,in accordance with SRCAA Regulation I,Article H and RCW 70.94.200. For the purposes of renovation,demolition,and asbestos projects,reasonable times include,but are not limited to,any of the following:when renovation,demolition,or asbestos removal appear to be occurring or are scheduled to occur,and times when the Control Officer or duly authorized representative are investigating air quality complaints filed with agency and/or have reason to believe that air quality violations have occurred or may be occurring.No person shall obstruct,hamper or interfere with any such inspection. I certify that the information contained in this notification and any supplemental information provided is, to the best of my knowledge, accurate and complete. Business Name: J' _ ' r t _7_66 ag/ ' r Fax: 3',5':-.3'. Q1C- Phone: Mailing Addre : . ., __ 4 Jimoi% a Signature: Print Name:'tiJ/ Agency re Onl ❑ NOI Amendment Deficient: • XNOI Amendment Complete S-` 1 P Date&Initial Spokane Clean Air,3104 E.Augusta Ave., Spokane,WA 99207/myw.spokanecleanair.org/Ph:(509)477-4727 Fax:(509)477-6828 09/09 GRAHAM ROAD RECYCLING & DISPOSAL FACILITY 1820 South Graham Road * Medical Lake, WA 99022 * 509-244-0151 * Fax 509-244-0207 WASTE SHIPMENT RECORD • I. Work site name & mailing address: Owner's name: !.OWL h l +5 r'� 5��Jr� x, t, , fi 1 2 0 31 Telephone No.: ix,(, 2. Operator's name and address: Telephone No.: Specialty Environmental (509) 535-1313 262:6 E, Trent 4nnkana . •t Th 99202 3. Disposal site name: Graham Road Recycling & Disposal Facility Mailing address: 1820 South Graham Road, Medical Lake, WA 99022 Physical site address: Same Telephone No.: (509) 244-0151 Fax No.: (509) 244-0207 4. Name and address of responsible agency: Telephone No.: (509) 477-4727 Spokane County Air Pollution Control Authority 1 101 West College Avenue, Suite 403, Spokane, WA 99201 5. Description of Materials: 6. Containers: 7. Total Quantity No.: Type: Cubic Yards: C. - 12)A 3_x 2, 8. Special handling instructions and additional information: 1 9. Operators Certification: I hereby certify that the above listed material(s), is (are) not hazardous waste as defined by 40 CFR part 261 or any applicable state law. I hereby declare that the contents of this consignment are full and accurately described above by proper shipping name and are classified, packed, marked and labeled and are in all respects in proper condition for Transport by highway according to - applicable international and government reggations. Printed/typed name & title: ini,nwt4 s {v4Sa L Signature: Date: 10. Transporter 1 (Acknowledgment of receipt of rterials) Printed/typed name & title: Specialty Environmental Address & Telephone No.: E . 2626 Trent Spokane, WA 99202 509-535-1313 Signature: Date: • • 11. Transporter 2 (Acknowledgment of receipt of materials) Printed/typed name & title: Address & Telephone No.: • Signature: Date: 12. Discrepancy indication space: 13. Disposal site owner or operator: Certification of receipt of asbestos materials covered by this manifest except as noted in item 12. Printed/typed name & title: Signature: Date: Waste Manifest(Grandm Road Landfill) 2/98, 12/99 f 311 N SARGENT - �%/ Z /; /I I ,./t--,-/-.-ciiffihp-z,//://///1„-\,,,,>-,,,,,,„/,,, /,/,,,,-/„.-/_„7,-,>„-_,,,-,,;, ///l/ - - - , - -/ „7--;2--- -;--, i i/�f ///, �// ////�r//r /// //// , /y7,-,, ,,„/„_„,/,„/„-.2,/,, /,-,-.2,,,,,/, ,,,,,,,,,,,,,,,,,,/,,,,,/,-;// NORTH' / / / , 7/=;=///,//:,,=,-Z7,=,---; � �� '////'-',-/--1- =/,',',,,,64 /x-- ./ // /' / /// r/ ii // i/ffjj OT�i'--( / , if, / , , !/ / /f/1, ///r / % f, ,,/ / /! / -j-4x-7/2 / ,f;/7/f/, ;, f; / //7/Z/.1i6;i614/=//;':-':2;=,'-'',/;y:=,:22/--';'/.',-,/,',/,/,-,;(;‘,„61,6=,/,--,/////, ,/,:,, , ,=/,,7-=//=1//'-- / ' -7/-27= --='-= -//=/-x=z--v-/,',-/-.---/-/-//- - - , - ---/-iit, -___4.k.. , , ,,z ,/,/,,,,,,,///7///,,,,,,/,,,/_,, ,,,,,,,,//,/,/7//,,,,,./zv,,,,___// r 7,-. /../--,././,-;:;,,,,,,,/,----,-,-,/,-,;--/,- -/--,-,-,/,--/--.--,-- /,/,,/,-///, :////,'7//;-/z--/ - j1/'�j'/`f ;/% /;%�j //// /// -2 ,-./.---;x4,-;, '//%% /`/'- /11////'/-/-7-----------%=//,--,--- -/-yizz_f_.,/i/ f--/ , ice/zr; //"'// ,�/--//7//://i--,/:-..-/:,-,----:/ .-t-r60ffc6rp-Ali /---- ///-;--,-07,-,iii4--rin/,'zz,-;-,2z--,--_-:;,-z-,-:,-,;,,-..--,-/:- /,/,,//,---:,/,::,/,-,;:-. - -/ -/ / / NOT TO SCALE 1 S AK E w Rot ,