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2015, 03-09 Permit App: BLD-2015-0418 Demo Bldg ;03/09/2015 MON 10:39 FAX — Z001/006 Project #;:R 0[S— Ott e S Development Department R EU1h E) lial / Permit Center 0 � 11703 Fast Sprague Avenue,Suite B PERM M CUYjj Spokane Valley,WA 99206 / U L015 Valley. Tel: (509) 6720-52108 -003 Fax: (509) 0037 PERMIT FEE: permitcen[erOsacgkanevallev 9[q 'rt✓S V P t N iVl i I ( r I' I t h # I REV. i ) DEMOLITION PERMIT AP_ ___.____ PRRESS:OJECT ADD '%�Oa E, y. 4?'.� ,�a, C edlizi ASSESSORS PARCEL NO.: �'i I BUILDING OWNER NAME: / 4 i rill + ,, ., g_ I! [ , ,, i -'JA e a Di y MAILINQ ADDRESS' a7 I II Iv. Mal• r 4el'i lee CITY' STATE' ZIP: 4 9 A#7 CONTACT PERSON NAME: TrIt e e 1 191,1-t rid9 PHONE: a�I FAX: 3- _.,—BOOS CELL: AJ CONTRACTOR NAME: / r , A 1 14 A •. . . , .'44 . • MAILING ADDRESS: &0 5- 1'fs L i r R Q 4 , ` CITY: STATE: le* ZIP: 11162- PHONE: SIC I•5 a 5-- 72 ö 3 FAX Q - sag_ a13 f i- CELL: A q�� / 0., CONTRACTOR LICENSE NO.: �A'RR YJP 9 EXPIRES: I ii / o I& CITY BUSINESS LICENSE NO.:• ,i �7 P• •JECT DESCRIPTION (Please Provide Site Sketc . �", Site Plan Provided ula Notice of Intent# los--Js---d Q e L Eti Spokane County Utilities has approved the disconnection Describe the scone of work in detail ..1d_cof ' i JAE 4II it r_. • 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 -• 'red to be submitted and subsequently approved before this application can be processed. • Signature % / ,/,. :/ o e414 Jf-:�� Date: 3/9 aO • If- Updated 1-11-11 Page 1 of 1 C:\Users\H.J. Excavation\Documents\Projects\2015- WSDOT NSC 2015 Demo No 1\Demo_Permlt.doc Received Time Mar. 9. 2015 9: 08AM No. 1566 03/16/2015 MON 11:38 FAX Z004/011 2015-0094 Page 1 of 1 • 2015-0094NOTICE OF INTENT March 6, 2015 Spokane t�,;, . Notice of Intent No. C1 Re ° AlrAyancy' FOR ASBESTOS PROJECTS/DEMOLITION Dntc NOI Received Rcvicw Spokane Regional Clean Air Agency(ARCSS)Regulation L Article DC and Section 10.09 for applicable requirements. A. Project Type: Demolition,No Asbestos Removal Does this project involve a fire-damaged structure? NO (If yes,rofer to Sections 9.03.F.3 and 9.08) • • Does this project involve demolition by fire training? NO (Sec Sections 9.02.1,9.03,F.4&9.04A6i) How many contiguous structures does this project involve? 1 Maximum of S structures per Notice of intent(NOI) B. Property Owner: Washington State Dept of Transportation Phone: 509-324-6000 Pax: 509.3246005 Mailing Address: 2714 N.Mayfair Street City: Spokane State: WA Zip: 99362 C. Site Address Contact Person: Mark Johnson Job Site Phone: 509-520-9308 Structure#1: 4502 E 4th ST(House) If>1 StraCturc,provido details to identify Structure#2: Structure#3: Structure#4: Structure 115: • D. Material Presumed: NO Asbestos Survey: YES Date Performed; September26,2014 AHERA Bldg.Inspector Name: Todd A.Lewis Cert,No.: 811120140926 Company; Mountain Consulting Services LLC Asbestos Found? YES E. Asbestos Removal Smrt Date; N/A Completion Date: N/A For each structure listed in section C,itemize the type and quantity of asbestos-containing materials to be Do materials include disturbed or non-intact asbestos? NO removed.Also indican which structures)will be demolished_ Structure#1: Demolition • Total Linear Feet: 0 Total Square Feet: 0 Abatement By(if known): F. Demolition Information Start Date(earliest): f March 16.2015 Demolition By(if(mown); G. Asbestos Project&Demolition Notification Waiting Period and Non-Refundable Fee Categories Your advance notification period will begin when a cr_traaggyj NOI,including required fees,is received by SRCAA. Check/complete all boxes which apply,below. Not owner-occupied.single-family residence Waiting Period Fee Demolition No Waiting Period $250.00 Surcharge - $9.50 $259.50 paid on 3/6/2015 at 11:21 am • H. Aknowledgement Name; Carol Johnson Phone: 509-525-7203 • �'rrr- .t tv.•,. __,, _ ocal/Temp/ZEPG1KMk.htm 3/6/2015 Received Time Mar. 16. -2015 10 06ANr No. 1608 03/16/2015 MON 11:38 FAX —i003/011 •• s • • `tJ BEDROOM . • e LIVING ROOM • 009;:. i' �� . . • •BEDROOM • • 1m Cm eii KITCHEN ® scr BEDROOM Q © BATHROOM • 7 g • . • • ®(g) BASEMENT LAUNDRY ROOM , • • GARAGE • ( LEGEND `::/ Indicates Location of Sampling Point ` IOi ----A, i """f" PRE-DEMO ASBESTOS SURVEY BULK SAMPLE LOCATIONS SITE DRAWING tl� 4502 EAST 4TH AVENUE, SPOKANE VALLEY, WASHINGTON DRAWING No. 1 Of 9922 E Montponery Dri Suite 9 DRAWN BYE CHECKED BYE PROJECT NOS 1 Sp�oknne Vnlle�y�VA 99206 T Lzvm p. vu rcrm I�-p 09 DRAWING NOT TO SCALE DRAWINGS Received Time'?Mar�16. -2015-10: 06AM_No, 1608—