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2011, 03-07 Permit App: 11000528 Demolition Garage, Particial ResidenceSpokane Valley Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 720-5240 Fax: (509) 688-0037 permitcenter@spoka neva l lev. orq (Staff Use Only)( PERMIT NUMBER: , , ' 1: � (- PERMIT FEE: l (j DEMOLITION PERMIT APPLICATION PROJECT ADDRESS: 2 ( I N. 1,/N(1v ,2D ASSESSORS PARCEL NO.: / & tl . o f, ,-/ BUILDING OWNER NAME: e2.,/ F7- l L c nt MAILING ADDRESS: CITY: C 1414-11-4-11,L) ' STATE: ZIP: CONTACT PERSON NAME: _-( 24 -5 7 i—[ 6. AJt ?9003 PHONE: 23 FAX: CONTRACTOR NAME: ~4-55 (iws-r-vc-r-fL-7ti CELL: 3/9 $3 S Z /.NC MAILING ADDRESS: ZgS � � N - N C,J Ao 4 CITY: PHONE: II S. --oris STATE: w0-- FAX: CELL: ZIP: ?/ Zo 7-��sSSI /65/ CONTRACTOR LICENSE No.: Com i'4 C (O c OC4 EXPIRES: 14//z- //? i CITY BUSINESS LICENSE NO.: P OJECT DESCRIPTION (Please Provide Site Sketch) ite Plan Provided Hi Notice of Intent # 175NSpokane County Utilities has approved the disconnection Describe the scope of work in detail V e cAtl d 4414s n Nn y )0v &tc swc rat() (60/41/44-6:—E— ./4-04 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 Date: 3 /-2 /ri Updated 1-11-11 Page 1 of 1 C:\Users\Kevin\Downloads\Demolition_Permit_1-11-11 (1).doc 4 89' • 53' 46' House NORTH ==> 43' N Union Road 124' PLOT PLAN Job Address: Owner: PARCEL #45164.0340 NO SCALE 211 N Union Road Spokane Valley, WA 99206 Elizabeth Lind/509-238-6882 Contractor: Compass Construction Inc 2824 N Nevada Street Spokane, WA 99207/509 532-0055 SRCAA, 3104 E. Augusta Ave., Spokane, WA 99207 / www.spokanecleanair.org / Ph:(509)477-4727 Fax: (509) 477-6828 9/10 1,1 h o0 1A, NOTICE OF INTENT MAR 0 g 2011 Notice of Intent No. Agency Use Only Spokane ►"' Regional �I �''' Clean AirAge��,�, FOR ASBESTOS PROJECTS / DEMOLITION SP�i��>ON�e Only Review Spokane Regional Clean Air Agency (SRCAA) Regulation I, Article IX and Section 10.C9-fir-a�p� gkt' r� #`.r"" A. Project Type: ❑ Asbestos Removal ❑ Asbestos Removal & Demolition Demolition, No Asbestos Removal Does this project involve a fire -damaged structure?: C&Yes ■ No (If yes, reflr to Sections 9.03.F.3 and 9.08) Does this project involve demolition by fire training?: • Yes Nf ,No (See Sections 9.02.R, 9.03.F.4 & 9.04.A.6.f) How many contiguous structures does this project involve? (5 max): I (If more than 1 structure, refer to Section 9.04.A.3) B. Property Owner: Et i Z4 6e To- LI ND Phone: 23g- (i'(2_ Fax: Mailing Address: PO gDK (/.S/© City: C ATITA`2y State: WA Zip: 99103 C. Site Address: 2-11 14 • ✓n►lcn! 0-ther0 City: ffd1/at'/all State: MA- Zip: gf2A6 Contact Person: VV i N SE's -12— /00 rviacc ca .Sr-rwc_v-rew INC Job Site Phone: SQ`(1.32 COST D. VI, Asbestos Survey or Date survey performed. 1 / 2 / t a AHERA Bldg. Inspector Name: T (.( p,t1Axtil Q Material Presumed Was asbestos found? ❑ Yes ►1 No Company: 12S co /1 orpvezfaiCert. No.: /0 7K `i Z E. Asbestos Removal Information: Start Date: Completion Date: Abatement By (if known): List individual type and quantity of materials to be removed. If >1 structure, list materials for each structure Total Linear Feet: Total Square Feet: by address / location. Will all asbestos material be removed from the structures) by project completion? ❑ Yes ❑ No . F. Demolition Information: Start Date:.„,Demolition (earliest) '' 111 By (ifknown): j' COW -pa -SS 61 NIS - i NC ` G. Asbestos Project & Demolition Notification Waiting Period and Non -Refundable Fee Categories (additional categories on pg. 2) Your advance notification period will begin when a completed NOI, including required nonrefundable fees, is received by SRCAA. Owner -occupied, single-family residence (see the Renovation, Demo., & Asbestos info. sheet) Waiting Period Fee 1. ❑ >_ 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. ❑ 10-259 In ft and/or 48-159 sq ft asbestos (also for <10 In ft or <48 sq ft per Sect 9.04.A.6.a) 3 Days $250 4. ❑ 260-999 In ft and/or 160-4,999 sq ft asbestos 10 Days $500 5. ❑ >_ 1,000 In ft and/or >_ 5,000 sq ft asbestos 10 Days $1,250* 6. [l All Demolition 10 Days$250 H. Optional: List additional parties you would like copies of this NOI and/or related notices sent to (list name & fax number and/or mailing ad ss): I. 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 the 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 thebest of myknowledge, accurate and complete. Business Name: e,„„4.•fC c ��-�""t. ;IOC_ i' Fax: <'. 49 3N lib YC--- Phone: 5'0 C3Z NOBS Mailing Address: 2g PI ti. N c J 404 cr.r cr.,s L! et-. IE via_ et 9 Z D 7 Signature: i _/f.A��. Print Name: [Lev c tv c2. n 2 ❑ NOI Deficient (see page 2) NOI Complete " (, C" Date & Initial Page 1 of 2 Agency Use Only:Date & Initial SRCAA, 3104 E. Augusta Ave., Spokane, WA 99207 / www.spokanecleanair.org / Ph:(509)477-4727 Fax: (509) 477-6828 9/10