2013, 05-30 Permit App: BLD-2013-0988 Demo MH f a
Community Development Department (Staff Use Only)
Permit Center
(CITY(N u„ a
Spokane 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Spokane Valley, WA 99206
Valley Tel: (509) 720-524068003PERMIT FEE:
40100
Fax: (509) 7
permitcenterc spokanevallev.orq
DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS:17222 EAST 3RD
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME:MOBILE HOME
MAILING ADDRES5:514 S.ARC ST.
CITY:SPOKANE VALLEY STATE:WA ZIP:99016
CONTACT PERSON NAME:DAVE SEYFERT
PHONE:509-926-4060 FAX:SAME CELL:509-998-8258
CONTRACTOR NAME:I GOING TO TRY TO DO IT MYSELF BUT MIGHT CHANGE TO LARSON DEMOLITION
MAILING ADDRESS:SAME AS ABOVE
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE NO.: EXPIRES: CITY BUSINESS LICENSE NO.:
PROJECT DESCRIPTION (Please Provide Site Sketch)
1 Site Plan Provided Eg Notice of Intent #2012-0217
Spokane County Utilities has approved the disconnection
Describe the scope of work in detail
THIS IS A SINGLE WAY MOBILE HOME THAT WAS GUTTED WHEN I PURCHASED THAT LAND AND THE OWNER GAVE ME THE TITLE
TO THE HOME,.THE POWER WAS TURNED OFF AND IT IS ON A SEPTIC SYSTEM.
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 an4 subsequently approved before this application can be processed.
c. 'y.. f" %/
Signature (4(' Date:5.30.2013
f
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Updated 1-11-11 Page 1 of 1
C:\Users\Dave\Desktop\17222 E 3rd\demolition_permit_5.13.13.doc
05/13/2013 12:14 5093243603 SRHD EPH PAGE 01/02
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SP•O'KANE COUNTY HEALTH DISTRICT
E. 0. PLOEGER, M. D., M:P.H, HEALTH OFFICER
N. 819 Jefferson Street
Spokane, Washington 99201• TE
PERMrr NO. / 2 L No. A 13056
APPUCATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
Name - /- • /_ 440 -14.. Address one No 417----$471
Address of Proposed SRo JY J Type of Use '.1 r•* AI.. Is brament for building planned?
Number of sethooms / �`tf'.... ng Capacity Camp Capacity Other
Water Supply �✓ (City, Wall. Springt, Drywall —"
Septic tank capacity )9‘6
5^) gals. Style of link
Length of disposal field / 6 - Absorption Pits _ _ Leach sed
UI Saar relative Iseallea oh Pfeps..d Muse, F lla lank,
dllpeel field, well. caress and ether lit telMinke
(2) Make Mea at wry haver Ow at Nampa Ina or ear
Mk, %WON apdeaulk dSI Ile. •
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Installer 4, / ( .�
Final Inspection Date rri/a/..+ci
Remarks:
The iocatiat
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IWAMOTOR V2-'1 (..e"-01
en .144 Rer. heM►rN For Spoken Solana Health District
Spokane Regional Clean Air Agency - Print NOI Page 1 of 2
:M
pokane
Regional el Y 1 r
a " i Agency
Print NOI
Back
Customer Information
Company:
Owner: Dave Seyfert
Contact: Dave Seyfert
Email: dkseyfertf q.com
Phone: 5099264060
Address: 514 S. Arc St.
Spokane Valley, WA 99016
Licensed Asbestos NO
Abatement Contractor:
Demolition Contractor: NO
Property Owner: YES
Other:
NOI Information
IDNUM: 2012-0217
Project Type: Not owner-occupied, single-family residence + all demolition
Additional Info:
Fee: $250.00 (PAID)
Property Owner: Dave Seyfert
5099264060
514 S. Arc St.
Spokane Valley, WA 99016
Site Address 1: 219 S Flora
Spokane Valley
Site Contact: Dave Seyfert
5099264060
Multiple Structures: 1
Asbestos Survey: YES
Material Presumed: NO
Asbestos Found: YES
Survey Date: 1/8/2012
Inspector:
http://www.spokanecleanair.org/print_noi.asp?id=1420&template=false 5/13/2013
Spokane Regional Clean Air Agency - Print NOI Page 2 of 2
Dave Seyfert
IRS Environmental
#BIR-12-014
Project Dates: -
Structure Quantity Type
Removal By:
Removal Completed: NO
Materials:
Contractor:
Demolition Structures: 1
Demolition Date: 6/23/2012
Demolition By: Demolition Contractor
Larson's Demolition
Job #00000
Unknown
Unknown
Unknown
Unknown, WA 99201
Fire Damage: NO
Emergency:
Alternate:
All asbestos to be removed by project completion: YES
NOI Submit Date: 6/13/2012 1:35:05 PM
Amendment #1
Change in Type:
Other:
Structure Quantity Type
1 900 Nonfriable Roofing
New Asbestos Start Date:
New Asbestos End Date:
New Demolition Start Date:
New Demolition End Date:
New Contractor:
Reason: Cancelling a notification
Amendment Date: 10/19/2012
http://www.spokanecleanair.org/print_noi.asp?id=1420&template=false 5/13/2013