2010, 08-24 Permit App: 10002617 Demo Garage 8CITY Permit Center
11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: '-Z�`
Spokane Valley,WA 99206 PERMIT FEE: \
valley. (509)688-0036 FAX: (509)688-0037 7.
www.spokanevalley.org
Community Development
Demolition Commercial
Permit Application 14 Residential
SITE ADDRESS: 15 10 l4V 1 , b V 2 , PD , VA1 \ W l l D.b(c)
ASSESSORS PARCEL NO:
Building Owner: Contractor:
Name: ,► \ CARvE�`l-� Name: cip,W
Address:s)O s l,bw2. go Address:
CitycclOp, VA t I Ey Stater A Zip: `1 qac City: State: Zip:
Phone: (�ll �� `tQ�_ �`3 Fax: Phone: Fax:
� Contractor Lic No: Exp Date:
Contact Person City Business Lic.No:
Name: 1U2xv\
Phone: (Is- -
Describe the scope of work in detail
TE1/(1 OL t 1-1 p k) d(= Ey aA02l0‘C-
ts1 A site plan is provided.
'. Spokane County Utilities has approved the disconnection.
Notice of Intent # 10— 013a-
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 develo ment rights granted by any issued permit inure to the property owner.
Signature � .1 Date a4
Method of Payment:
14 Cash ❑ Check ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/16/07
r . i pl E C E WED
/0-0/321.
NOTICE OF INTENT I IAUG 2,4 2010
Notice of Intent No. iSpokane \"
S
pRegional 4 ''' FOR ASBESTOS PROJECTS/DEMOLITION
Agency Use Only 1 Clean Air , SPOKANE REGIONAL
Refer to the Agency's Renovation,Demolition,and Asbestos Information Sheet as well as Regulation I,Article IX
A. Project Type: Asbestos Removal I I Asbestos Removal&Demolition .n.Demolition,No Asbestos Removal
Does this project involve a fire-damaged structure?: ❑Yes ,No (If yes,refer to Sections 9.03.F.3 and 9.08)
Does this project involve demolition by fire training?: ❑Yes Inl,No (See Sections 9.02.R,9.03.F.4&9.04.A.6.f)
How many contiguous structures does this project involve?(5 (If more than 1 structure,refer to Section 9.04.A.3)
max): )
D. Property Owner: d.1a12i•n12Vt.t}{ Phone: jq5-(pi43 Fax: ` --
Mailing Address: )5(0 j . WI!butt RD- City:5p.VAS I.. .
y State: WA Zip: C e�eo
C. Site Address: . 41-y City: State: Zip:
Contact Person: SAME. Job Site Phone: 51Ai'Y1E
D. A Asbestos Survey or Date survey performed: gj—8—I 0 AHERA Bldg.Inspector Name: 14 11pkg i 0 v 11A
111 Material Presumed Was asbestosNj0 El '-�
Yes [X] No Company: Cert.No.: Q�- 1D-o
ACIP
found?
D
E. Asbestos Removal Start Completion Abatement By
Information: Date: Date: (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 structure(s)by project completion?Ti Yes n No
F. Demolition Start Date: Demolition By
Information: (earliest) L3• •Its (if known): 10• I_)04
G. Asbestos Project and Demolition Notification Waiting Period and Non-Refundable Fee Categories
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.Iii 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 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. ❑ All Demolition 10 Days $250*
*The$250 demolition fee is waived if demolition is performed in conjunction with asbestos project category 3, 4 or 5, 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 situation:
❑ 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 durin,-the asbestos survey.
❑The project must proceed to avoid imposing an unreasonable financial burden'l -- .
Alternate Asbestos Project Work Practices Reference Waiting Period Non-Refundable Fee
8. ❑ Alternate Asbestos Project Work Practices Section 9.08.A 10 days Twice the Regular Fee
Page 1 of 2
Spokane Clean Air,3104 E.Augusta Ave.,Spokane,WA 99207/www.spokanecleanair.org/Ph:(509)477-4727 Fax: (509)477-6828 09/09
� o
X •