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2005, 05-20 Permit App: 05001716 Demo Residence • BUILDING PERMIT APPLICATION WORKSHEET Strioliallrile\l" City of Spokane Valley Community Development Department Building Division p 11707 E. Sprague Avenue, Suite 106 .0,04Val le Spokane Valley, WA 99206r Phone: (509) 688-0036;Fax: (509) 688-0037 • REQUIRED SITE INFORMATION Street Address: 5620 E. 3k.0 Assessor's Tax Parcel Nurnber(s): • Legal Description: dial mum PERMIT DESCRIPTION: ilit 1. Fie ❑ Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety [3 Other OWNER/APPLICANT INFORMATION ® Owner. ram w,vciE © Applicant Larsm's Danaliticn, irr. Phone: c-4556 Fax: 534-4836 Phone: 535-7944 Fax: 535-8087 • • Address: 1118 N. }A3. Address: P.O. Bx 4535 Sp3ane , VA 99212 .5bolcane, VA 99220-0535 City State Zip Code City State Zip Code [J Contractor- Larsrn's Darolitim, irr- 0 Architect: Phone: Fax: Phone: Fax: Address: Address: City State Zip Code City. State Trp Code WA State Contractor License#:TARSTE164RJ Contact: Jeff tarsal • PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: #OF STORIES: 30X35 1'-- MAIN FLOOR TO SQ. FTG: 2"®FLOOR SQ. FTG: UNFIN BASEMENT SQ.FTG: 1050 FINISHED BASEMENT SQ. FTG: GARAGE SQ.FTG: DECKICOV.PATIO SQ.FTG: OCCUPANCY GROUP:- CONSTRUCTION TYPE: HEAT SOURCE #OF BEDROOMS: TOTAL HABITABLE SPACE IMPERVIOUS SURFACE AREA: COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC - SYSTEM? Method of Payment: (Faxed permit applications will only be accepted with major bankcard) O Cash ❑ Check D Mastercard ❑ VISA 0 Other Bankcard#: '. Expires: VIN#: - - Authorized Signature: 4$49 -- t/08 F-354 • D5-1D-D6 01;3$PY1 F hSCAPCA T-.148, P.0. spo7sicauatustorturivr.I sir, re51 414' . • 05-0.15- • myrkftewmarr ,..,..L.)__, ., . . , . - , „.........., . -, ..i., *...,., ,_ I h 7Q t QA — .z. 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Skregiene Ae:ato oli }mss k ks1r �4�so la OW Un __ lfelobmr�. Nor Ni"ae #,a++aaw�asosae�pt Ni" Whet VA-- / • NairI D6-O0S now MO- t *PG PAC ai r kADAtIctieue ,.--we . }\ Itl . N 4 e)Loa RA) L-L.Lw -Iqt..1) Csii1Z S ' Atrai Use Oaly • SPOKANE COUNTY MR POLLUTION .• • CoNTROL A:rrnoBY Cage Na: 1101 W.Cdkse.•Suite 403,Spokane;WA 09201 • Phone(509)4?7-4727,FAX(*)477-682$ A No.: ; --!-NOR CATION AME ND M E N T - ELASBESTOS P OXECT ®DEMOLITION PROJECT Caatract ,, •1 G . :. ; , `, Owner/cu. ff• or. s o. .�� Phone:(so9):. c hy:Spokane Slate: WA Zi>r 99116 Aim ( ALL AMENDMENTS kQWPZ AExctx-x WuuK S HEDULE CHANGES FOR =NTRACTORS PAItTICIPATI'NO IN THE WORK SCHEDULE FAX PROGRAM "nit PEE MUST BE ATTAcm TO EACH AMENDMENT. ANY AMENDMENT/HAT-CHANGES 213E PROJECT TYPE OR PROJECT CATEG4a:Y s SuRTBC'C'ro THE NEW NOTW1CATION PF.RIott roR ANY AMEND ENT WHERE THE PROJECT'TYPE OR P9e I CATEGORY IS ASSOCIATED WITH A HIGHER FEE,A FEE EQUAL TO THE DTPFERENCE BETWEEN ME FEE/SLATED WITH THE MOST RECENTLY SUBMITTED NOTIFICATION AND THE FEE ASSOCIATED WITH THE DtCYtum)PROJECT 'tYP6 OR PROJECT CAy't,GORY SHALL SB SUBMITTED1N ADurnow TO THE S50 AMENDMENT PM PLEASE ^"RRENT i a ON INFORM/ BELOW: AGENCY G + .. •_• CAT ma. _ ,CONTRACTOR JOB t..,• r" JOB srfE ADDRESS?::,._ _.: PLEASE ENTER AMEND'CHANGES BELOW: o NEW PROJECT TYPE: fl NEw JOR SITE ADDRESS: 0 kigg DEMOLITION STARTING DATE: . Q MULTIPLE STRUCTURE PROJECT: (Attach map,site addresses.type and amount of asbestos tosteri=I&work sd%edok) • rig pm PROJECT STARTING DATE: comp1.B11ON DATE::_, •" • (� NEW WORK SCHEDULE DAYS: M T W WI P SI SU; WORK SH1FT froU Rs: o ADDITIONAL QUANTITY TO BE REMOVED SQUARE rT UNEAR FT (NE . O0IAOE TOTALS: _ SQUARE FT _LINEAR PT)• o NEW TYPE OF MATERIAL To BE REMOVED(PLEASE INCLUDE THE QUANTITY FOR EACH TYPE). • r - 100 HEREBY CERTIFY TRAT THE II FORMAT ION CONTAINED IN TRIS APPLICATION AND SUPPLEMENTAL DATA DESCRIBED HEREIN IS,TO TEE BEST OF MY RHOWLSIXE,ACCURATEAND AGENCY WB QCLY 41111r , COMA MA Y,.1,111116-5. ,�,N _�• •J��• �'S- _ -JG ..MMT 1 TELEPHONE: (s. 'w PAX:(3091 —: ;-a:..„ W cdtiafA Mt(66414 J F '1 :tt lEE.ER IND FAX NO. :509-434-4836 Mau. 09 2005 09:fids' >i • LIMITED ASBESTOS INSPECTION PRIOR TO DEMOLITION 5620 EAST SHARP • SPOKANE VALLEY,WASHINGTON • 1.0 INTRODUCTION prior to demolition IRS Environmental of WA,Inc. has completed an asbestos inspection asoa The survey of the Wheeler residence at 5620 East Sharp,Spokane Valley,Washington. for asbestos containing building materials was completed April 25,2005 at the request of Lloyd Wheeler by Dave Seyfert,:t certified AHERA Building Inspector under 40 CFR, Part 763,Subpart E,and Appendix C(Certification No.1015127).This report presents the asbestos survey methods, findings,and conclusion. ZAO'URPOSPS AND SCOPE various local,state, and federal regulations govern the use and management of asbestos containing materials(ACM). The codes are generally focused on preventing airborne emissions of asbestos fibers and f.ddressing public and worker health concerns for exposure to asbestos during demolition projects. 3.0 SU§PECT MATER> ilES=ED FOR ASBESTOS CONTENT The number of samples taken for any surfacing material is determined by CFR Part 763.86,which requires- -3 samples for each material that is present in quantities of l 7000 SF or less. -5 samples for each material that is present in qualities of 1,000-3,000 SF. -7 samples for each materiel that is present in qualities of greater than 5,000 SF. In some oases,the inspector is allowed to USC discretion and take fewer samples of factory manufactured(not site erred)materials such as VCT, ceiling tile,and roofing. The following materials were tested for asbestos content at the request of the client: • Black/yellow/grey linoleum-kitchen wall • Black/yellow linoleum--kitchen wall • Gold/grey masonhe•-•kitchen wall • Joint compound-patch kitchen light switch • Gypsum wallboard-upper level and basement • Plaster-kitchen wall • Grey floor tile and adhesive-kitchen • Pale yellow/yellow linoleum and adhesive-living room • Panel adhesive-living room • Plaster-typical throughout • Tan floor tile and mastic-bedroom main floor • Window glazing • Slack/red linoleum-bat uuum hall • Thin set-bathroom hall , FROM :IME.H4 IND FAX NO. :5O9-534-4936 May. 0'3 Oat i i 4ii P • Black/off white-bathroom wall • Yellow adhesive under linoleum-bathroom wall • Yellow cove base and adhesive-bathroom hallway • Grey attic insulation • Yellow wallpaper-upper level • Brown fiberboard and backing-upper bedroom • Ydlow/bluelgreee/red linoleum and mastic-upper bedroom • Black/red linoleum-upptx closet • Black/brown/tan linoleum-upper bedroom • Roofing shingles • Grey chalk-around windows and doors • Black/green siding shingles 4.0 SUBJECT SUI DESCRIP'T'ION The subject site is a two-story wood frame residence with a full basement. The walls and ceiling art gypsum wallboard or plaster in the structure. Linoleum covers some of Cu! walls, Floor treatments are linoleum, floor tile with some carpet. Forced air heating unit provides heat. Fiberboard shingles are used for siding. The roof has three tab asphalt shingles. SuRYEY METHODQLQGY The scope of services included identification()finny suspected ACM within the specific areas that will be intpau ted by upcoming demolition activities,to bulk sample and analyze those suspect materials and to provide a report of findings. A general walkover examination was initially completed to plan the asbestos survey,identify functional spaces(spatially distinct areas within the work area).and to develop a sampling scheme • for homogeneous areas of suspected ACM.The interior ceilings were visually inspected for suspect ACM.Bulk samples were collected in a representative manner by the inspector based on suspected material contents,as defined by regulatory codes or guidance's for sampling methods and as applicable to the planned demolition activities, The samples were placed into airt,ght plastic bags provided by the laboratory.The samples wete placed into airtight clastic bags. The samples were hand delivered to Mountain Laboratories at 10905 E.Montgomery Ave.,Spokane,WA A NVLAP accredited laboratory for the analysis of bulk materials using PLM. 6.0 IDE41T IF15 D ASBESZQS CONTAINING SAMPLES-Ft1 INGS The following represents a tabulation ufbulk samples,which were found to contain asbestos during the preparation of this survey and the results of their analysis. S mats#s Materialikscrintion/Area Content SF/LF 7286-06 Pale yellow linoleum 35-40% 350 SF Living room 7286.10 Tan floor t lie/Upper bed room 7-1 u% 156 SF 7286-12 Black/red linoleum/bathroom ball 40-45% 28 SP