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HomeMy WebLinkAbout2012, 12-04 Permit App: BLD-2012-2210 Demo Fire Damage 19- eoz-- 2a Community Development Department (Staff Use Only) OP" Permit Center CITY OF 11703 East Sprague Avenue,Suite B-3 PERMIT NUMBER: Spokane Valley, WA 99206 Tel: (509)688-0036 PERMIT FEE: 40,000Valley Fax: (509)688-0037 permitcenter@spoka nevalley.orq DEMOLITION PERMIT APPLICATION PROJECT ADDRESS: 15911 E Wellesley Avenue ASSESSORS PARCEL NO.: 46363.0123 BUILDING OWNER NAME: Rosalee Baca MAILING ADDRESS: 15911 E Wellesley Avenue CITY: Spokane STATE: WA Zip: 99207 CONTACT PERSON NAME: Kevin Serr PHONE: 509-532-0055 FAX: 509-328-1645 CELL: 208-651-1651 CONTRACTOR NAME: Compass Construction Inc MAILING ADDRESS: 2824 N Nevada Street Crrv: Spokane STATE: WA ZIP: 99207 PHONE: 509-532-0055 fAx: 509-328-1645 CELL: 208-651-1651 CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.: P• •JECT DESCRIPTION (Please Provide Site Skech 10`( Site Plan Provided { Notice of Intent # I 1 -CO S S Spokane County Utilities has approved the disconnection Describe the scone of work in detail Demo fire damaged residential home less foundation. 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 permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional information may be requir d be submi nd subsequently approved before this application can be processed. Signature Date: f 2-W7 Method of payment: 0 Cash 0 Check ['Visa 0 Mastercard Bankcard #: EXP: VIN#: Authorized Signature: Effective October 28, 2007 Page 1 of 1 P:\Community Development\02 Administration\03 Forms-Official Versions\Permit Center\Demolition Permit App 10.28.07.doc • 1�©lsfldl-, ID / — ©&55• , NOTICE OF INTENT DEC 4 2012 Notice of Intent No. Regional Spokane ,,4 FOR ASBESTOS PROJECTS/DEMOLITION "' SPOKANE REGIONAL Agency Use OnlyClean Air _ _- --__Dar !p All?R 'Onl�- _— Review Spokane Regional Clean Air Agency(SRCAA)Regulation 1,Article IX and Section 10.09 for applicable requirements. A. Project Type: DI Asbestos Removal ❑ Asbestos Removal&Demolition Demolition,No Asbestos Removal Does this project involve a fire-damaged structure?: Yes D No (If yes,refer to Sections 9.03.F.3 and 9.08) Does this project involve demolition by fire training?: ❑Yes1No (See Sections 9.02.L,9.03.F.4&9.04.A.6.f) How many contiguous structures does this project involve?: i Maximum of 5 structures per Notice of Intent(NOI) B. Property Owner: goSA-the. ,6464 Phone: 40-g CO Fax: Mailing Address: i> q in '. of aa, C.Gf Ave City: 7�'/�/t/Gt State: ja//7 p: 7 * i L (O14tf S Clams T Job Site Phone: SCIZi '3ZQL(4DOSS C. Site Address Contact Person: � ;J � '�� p Structure#1: /f'*// 6., atgltESLL$`( S a e—frivi-7 wig- %i4L-/ If>1 structure,provide details to identify #2: #3: #4: #5: D. ❑Material Asbestos Date survey performed: //p..11/Z..- AHERA Bldg. Inspector Name: JO I , tN '�, -. / Presumed Survey: Was asbestos found? ❑ Yes Ur No Company: S eci'fury egV-Cert.No.: '/t-J"3 E. Asbestos Start Completion For each structure listed in section C, itemize the type and Removal Date: . Date: quantity of asbestos-containing materials to be removed. Total Linear Feet: Total Square Feet: Abatement By(if known): Will all asbestos-containing material be removed from the structure(s)by the asbestos removal completion date? ❑ Yes Cl No F. Demolition Start Date: / Demolition By 7tr. t�- �ra, 47d%^' Information (earliest) Z'�/ I /� (if known): G. Asbestos Project&Demolition Notification Waiting Period and Non-Refundable Fee Categories(additional categories-pg.2) Your advance notification period will begin when a completed NO1,including required nonrefundable fees, is received by SRCAA. Check/complete all boxes which apply,below. 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. 1 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(see below if>_2,000 In ft or>_10,000 sq ft) 10 Days $1,250 If>-2,000 In ft or>_ 10,000 sq ft,the additional incremental fee added to the$1,250 base fee is calculated as the greater of: Number of 1,000 In ft increments beginning at 2,000 In ft: x$250= $ I+$1,250 base fee= $ Number of 10,000 sq ft increments beginning at 10,000 sq ft: x$250= $ 1 +$1,250 base fee= $ 6.❑ All Demolition(this fee waived if project performed with project category 3,4,or 5,above) I 10 Days $250 H. 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. l certify that the information contained in this notification and any supplemental information provided is,to the best of my knowledge,accurate and complete. 32g ft YJ- ?vt,)P&S S (_e-A/ ( - 2 2-1 IV. IV•0A-.919 CI 9d4'? / a :'r r Business Name& dress: �J Signature: f 1-.t ._ f--^- -- Print Name: Ve V/Pi t2/z— Phone: 532 tVIS ❑ NOI Deficient (see page 2) X NOI Complete (1—+12— pane 1 oft Agency Use Only: Date&Initial Date&Initial b SRCAA,3104 E. Augusta Ave.,Spokane, WA 99207/www.spokanecleanair.org/Ph:(509)477-4727 Fax: (509)477-6828 3/11 ' 1 93' ► • • NORTHft 67' • 132' f- 28' ► 15911 E Wellesley Avenue ♦ 28' -► I 40' i v E Wellesley Avenue