2011, 09-23 Permit App: 11003011 DemolitionSplikane'�.jValley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3'
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter(ahspokanevalley.orq
(Staff Use Only)
3 1I,
PERMIT NUMBER: ` (
PERMIT FEE: LS S —
DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS: S1411 Winters Rd.
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME:
MAILING ADDRESS:.
S. 1411 Winters Rd.
Cur: Spokane Valley
CONTACT PERSON NAME: Arlene Lumpers
•
PHONE: 509 435-3580
CONTRACTOR NAME:
STATE:
WA ZIP: 9921 2
FAX:
CELL: 509 891 -7039
Larsons Demolition, Inc
MAILING ADDRESS: PO 80X 4535
Crnr: Spokane
STATE: WA
ZIP: 99220
PHONE: 509 535-7944 FAx: 509 535-8087 cEu_:509 994-3995
CONTRACTOR LICENSE No.: IAF JJI164RJ EXPIRES: 1 2 / 31 / 1 1 CITY BUSINESS LICENSE No.:600556997
PROJECT DESCRIPTION (Please Provide Site Sketch)
X❑ Site Plan Provided ® Notice of Intent # 2011-0347
® Spokane County Utilities has approved the disconnection
Describe the scope of work in detail
Dar liticn, gyral Wile Wic7e Mile FDre
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 v ation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be require, to be submitked apj subsequVfyy approved before this application can be processed.
Signature
Date: 9/23/2011
Method of payment: ❑ Cash ❑ Check ❑Visa ❑ Mastercard
Bankcard #:
EXP: VIN#:
Authorized Signature:
Effective October 28, 2007
P:\Community Development\Forms\Building forms\Demolition Permit App.1.doc
Page 1 of 1
S
1411 S. Winter Rd
N / "
NOT TO SCALE
N
E. Skyline
Winter Rd
W
When using any driving directions or map, it's a good idea to do a reality check and make sure the road still exists,
watch out for construction, and follow all traffic safety precautions. This is only to be used as an aid in planning.
http://maps.yahoo.com/print?mvt=h&ioride=us&tp=1 &stx=&fcat=&fiat=&clat=47.64432... 9/23/2011
09/22/2811 11:52 5099283933 IRS ENVIRONMENTAL
Spokane Regional Clean Air Agency - Print NOI
Sete
�'
Cte&n Airage,
Print NOI
Back
Customer Information
Company:
Owner:
Contact:
Email:
Phone:
Address:
Licensed Asbestos
Abatement Contractor:
Demolition Contractor:
Property Owner:
Other:
NOI Information
IDNUM:
Project Type:
Additional Info:
Fee:
Property Owner:
Site Address 1:
Site Contact:
Multiple Structures:
Asbestos Survey -
IRS Environmental of WA, Inc.
IRS Environmental WA, Inc.
Rob Reed
sarah@Irsenviro.com
509-927-7867
PO Box 15216
Spokane Valley, WA 99215
YES
NO
NO
PAGE 32/33
Page 1 oft
2011-0347
Owner -occupied, single-family residence + all demolition + >= 10 In ft or >=
48 sq ft of asbestos removal not performed by the residing owner
$30.00 (PAID)
Arlene Lumper
509-435-3580
7921 E. Beverly Dr
Spokane, WA 99212
1411 5 Winter Rd
Spokane
Alan Rasmussen
509-998-0802
1
VES
htrns•//www_ cnnkanecleanair.ora/orint noi.asp?id=1055&template=false 9/15/2011
09/22/2011 11:52 5099283933 IRS ENVIRONMENTAL
-Spokane Regional Clean Air Agency - Print NOI
Material Presumed: NO
Asbestos Found: YES
Survey Date: 4/11/2011
Inspector: Jeff Robinson
IRS Environmental
*107842
Project Dates: 9/26/2011 - 9/27/2011
Structure
1
Quantity Tyne
1400 sqft Roof Sealant
Removal By: Abatement Contractor
Removal Completed: NO
Materials:
Contractor: IRS Environmental WA, Inc.
013807
Rob Reed
509-927-7867
Po Box 15216Spokane Valley, WA 99215
Demolition Structures:
Demolition Date:
Demolition By:
Fire Damage:
Emergency:
Alternate:
All asbestos to be removed by
project completion:
NOT Submit Date:
1
9/26/2011
Demolition Contractor
Larson's Demolition
Job *00000
Jeff Larson
509-535-7944
P.O. Box 4535
Spokane, WA 99220
NO
YES
9/15/2011 8:31:29 AM
PAGE 33/33
Page 2 of 2
https://wvnv.spokanecleanair.org/print_noi.asp?id=1055d}template=false 9/15/2011
09/23/2011 07:03 FAX 4777198 SPOKANE CO BLDG.
SPOKEIIE Q
Rion
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Site Address: 1411 S WINTER RD
Parcel Number: 45193.0902
Subdivision: CONVERTED CNTY DATA
Block: Lot:
Zoning: UNIT
Owner: YARROA.L, HELEN
Address: 1411 S WINTER RD
SPOKANE, WA 99212
Building Inspector: MARK WALKER
Water Dist:
Sewer Connection Permit
Project Information
Project Number: 11004860 Inv: I Issue Date: 9t23/2011
Permit Use: ALTERATION TO EXISTING SEWER
Applicant: LARSONS DEMOLITION
PO BOX 4535
SPOKANE, WA 99202 Phone: (509) 535-7944
Contact: LARSONS DEMOLITION
PO BOX 4535
SPOKANE, WA 99202 Phone: (509) 535-7944
Setbacks -Front: Left: Right: Rear:
Group Name:
Project Name:
Permits
Contractor: LARSON'S DEMOLITION INC
Licensed: LARSODI164RU
ALTERATION TO EXISTING 1 5125.00 PROCESSING FEE 1 $25.00
Total Permit Fee: $150.00
**FOR SEWER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO
COVER. ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A30 -MINUTE INSPECTION. ADDITIONAL
INSPECTION FEES APPLY AFTER 30 MINUTES.
**CALL 1-800424-5555 BEFORE YOU DIG --AT LEAST 2 WORKING DAYS IN ADVANCE. SPOKANE COUNTY CODE
REQUIRES THE INSTALLER COMPLY WITH ALL REQUIREMENTS OF THE WA STATE DEPT OF LABOR & INDUSTRIES,
INCLUDING THOSE RELATED TO TRENCH SAFETY.
**INSTALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO THE SEWER AND MAY
BE REQUIRED '1.0 PERFORM TESTS FOR VERIFICATION. INSTALLER IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER EXCAVATION
**SEWER STUBS AND DRY SIDE SEWERS ARE TO BE CHECKED PRIOR TO CONNECTION TO ENSURE THAT THEY
HAVE ACCEPTABLE GRADE AND ARE CLEAR AND UNOBSTRUCTED. SEWER LINES SHOULD BE CONSTRUCTED TO
ALLOW FOR GRAVITY FLOW FROM THE LOWEST LEVEL OF THE STRUCTURE.
**THE INSTALLER AND THIS PERMIT MUST BE PRESENT AT THE JOB SITE AT THE SCHEDULED INSPECTION TIME.
BOTH STATE LAW RCW 19.122 AND COUNTY CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO
OWNERS OF UNDERGROUND FACILITIES.
Payment Summary
Total Fees AmountPaid AmountOwing Tran Date Receipt ft Payment Amt
$150.00 $150.00 $0.00 9/23/2011 4257 $150.00
Processed By: SHA3TO, JULIE •
Printed By: Force. Faith Page 1 of 1
PERMIT
INSPECTOR: 4>4 SPOKANE COUNTY UTILITIES SIDE SEWER INSPECTION REPORT
FINAL INSPECT. DATE: 9- ,d PIPE FLOW, TYPE & SIZE: iNGRAVITY 0 PRESSURE ❑BOTH i 4' PVC D-3034 0 6' PVC 0-3034 ❑ OTHER:
INSPECT. DATE(S): PROJECT No.: /0 4S9* SCAN ❑
ADDRESS .So. 1111 TA) =AATe"e? ROAD CONTRACTOR: MATY M.Zttc2
SEWER DISTRICT/SUB-DIV.: 1"019"141 QE1/E&6y 10145 PARCEL No.: 45/93 O"Joz LOT: BLX:
STRUCTURE AGE: ❑NEW ®EXISTING ❑VACANT LOT PARENT PARCEL No.:
STRUCTURE TYPE TYPE OF INSPECTION
IN SINGLE FAMILY RESIDENTIAL ❑ ATTACHED ADDITION ❑REGULAR CONNECTION ❑EXTERIOR DRY SEWER CONNECTION
❑ DUPLEX 0 TRIPLE( 0 FOURPLEX 0 ZERO LOT UNE ❑SEWER STUB ❑INTEERIOR DRY SEWER CONVERSION
❑BUSINESS / COMMERCIAL ❑MANUFACTURED HOME PARK ❑MAINUNE TAP ❑MAINLINE (PRIVATE) ❑CUT -IN WYE/TE
❑APARTMENT / UNITS._ ❑TOWNHOUSE/CONDO / UNITS_ ❑DRY SEWER ❑CORE MANHOLE ❑CUT -IN M.H.
❑ DEPENDENT RELATIVE 0 SHOP / GARAGE ❑TEMPORARY ®REPAIR ❑STUB ABANDONMENT
EASEMENT AGREEMENT REQUIRED? ❑YES ❑RECORDED ❑FOLLOW-UP 0 ADD-ON ❑OTHER (SEE COMMENTS)
WAIVER OF REGULATIONS REQUIRED? ❑YES ❑RECORDED ['SUBSTANDARD PIPE CONNECTION ❑OTHER (SEE COMMENTS)
DEFICIENCY: 0 TES 0 CONSTRUCTION 0 UNWIRE (SEE COMMENTS) 1 TANKS)ABANDONMENTINSPECTION: 0 YES 4 N/
N
COMMENTS: Q 5; -7n)6' .L I-4CS0 08 A.7�4E '4C. J ,' PUMPER:
Age/Para-0 - &- /
e" 7495
CAI?: -,fr 14, .21-+
8," . is 11 Pace/
W 1N {Cg
Q5
t3.5
s`/ 1 EY 130A/6".
1
)
INTERIOR PLUMBING
® YES ■ NO ❑ N/A
jiff-BILUNG NOT APPICABLE
❑ PENDING LIVE
• LIVE DATE:
SEE HMS ACCOUNT FOR
E BILLING INFORMATION
- - - - EXIST. SEWER UNE
m SHUT OFF VALVE
2 DRYWELL
BACKWATER VALVE/8WV
SS SEWER SRU*
❑ CONNECTION POINT
E.O.P. EDGE OF PAVEMENT
Gm GAS METER
ICIE ELECTRICAL
W WATER METER
CLEANOUT
POWER POLE
0 MANHOLE
4' STORM DRNN
0 HYDRANT
Q CENTERLINE
8.L. BUILDING LINE
aAvm WE rfH ARROWS . t *1U
aum SSCsrow OF sna JIB
S/W SDEWAU(
C a DEPTH
CS. CAST ETON
0.8. ORANGEBURG
FITTING
H.D. HEALTH DISTRICT
FND FOUNDATION ////
❑ COPY TO 8 & CE
❑ COPY TO HEALTH DIST.
❑ OTHERS: Y
NOM ARROW