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2009, 03-13 Permit App: 09000610 Demo Barn , Permit Center f'1 (n (0 Serror 11703E Sprague Ave,Suite B-3 PERMIT NUMBER: (/ D 1i/ pokane Spokane Valley,WA 99206 PERMIT FEE: 4.2(.O3 ......vatiey® (509)688-0036 FAX:(509)688-0037 u www.spokanevalley.org Community Development Demolition Commercial Permit Application Residential SITE ADDRESS: SCS-1 - tk-k- ASSESSORS PARCEL NO: 4 SabQ r d (5 Building Owner: Contractor: (� i, �l Name: 4c�t74 `�io5Auque / k-� � Name: kOcl%C'„,CSyOI Lotti Locu''5 Address: s r.. I_ [Qy g p h e Address: Q �©`. �Z3 q City: t..f lei , (Sttaat�e::���� Zip: l I�ei City: Vlr.o2�v�4' Cres State: WQ , Zip: l9clei Phone: 99 `Q�j l' Fax: Q l`tp Phone: cp` rig t► 4, Fax: r _( _l V t� h 'l ky' O Contractor Lic Ni? '�t.�A C zI �Cpktte: /' 10 v(6) Ceuta erson L City Business Lic.No: CO� C_._.3 3./ l9 Name: G11.40 a ,`\ ( l� 5 Phone: l`-t Describe the scope of work in detail IC- Q V-k-i() s....Stv.a letti-tiN 6(k._ Re_fely D o A site plan is provided. CITY OFy: t_ , BY VALLEY o Spokane County Utilities has approved the disconnection. MAR 13 2009 o Notice of Intent # 1� NEF31 11 jj H The permittee verifies, acknowledges and agrees by their signature that: 1)Ownership bf' ' II-.. - f Permit inure to the property owner. 2) The signatory is the property owner or has permission to -•. -nt 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 r suiting developme ' hts •• anted by any issued permit inure to e p operty owner. e Signature Date i 966 Method of Payment: n Cash ❑ Check ❑ MasterCard ❑ VISA Bankcard #: Expires: VIN#: Authorized Signature: REVISED 2/16/07 - * 0 a NOTICE OF INTENTr r ���` Al/ ``� ; �4 Notice of Intent No. 1Spokaneohm y _ Regional �' EOR ASBESTOS PROJECTS/DE�IOLCCIO� �,� se Only Clean AirAge _ _--_ _ - Agency Use Only f _____------ — � � � � 1 ___I --- ,...� Refer to the A.enc 's Renovation,Demolition,and Asbestos Information S ee I�_ � •. 31111 A. Project Type: CI Asbestos Removal Li Asbestos Remov. ; Demolition �molition,No Asbestos Removal f es,refer to Sections 9.03.F.3 and 9.08) Does this project involve a fire-damaged structure?: U Yes yr N. (See Sections 9.02.R,9.03.F.4&9.04.A.61)Does this project involve demolition by fire training?: U Yes iNo more than 1 structure,refer to Section 9.04.A.3) How many structures does this project involve?: (If B. Property Owner: 2,/grZ Phone: Fax:State: Zip: Mailing Address: Civ: ,�! �► , Zip: C. Site Address: 10 . Job Site Phone:��j – 'a Contact Person: i e ��i� �'��-(,.--- D. L-.1 Asbestos Survey or Date survey performed: AHERA Bldg.Inspector Name:r A�J���" Cert.No.: -55- 0-7/ 0 � U Material Presumed Was asbestos found? a Yes U No Company: j/ Completion By Ir. Asbestos Removal Start Date: iAbatement known Information: Date: x� �1 / , • �,:�1Egimiwrirr /rte filliall List individual e and � � �� r�7�d� I uanti of materials to be �m Iti removed.If>1 structure,listIIIIIIIITotal S•uare Feet: Total Linear Fe materials for each structurero ect completion? C Yes U No by address/location. Will all asbestos material be removed from the structure(s)by p j p emolition Start Demolition By / ��? �` i%' F. a (if known): /'7i.'v c.-e 2 In rmation: Date: 3 G. Asbestos Project and Demolition Notification Waiting Period and Non-Refundable Fee Categories Demo.,& Asbestos info.sheet) Waiting Period Fee Owner-occupied,single-family residence(see the Renovation, emo., Days $30 1. U All Demolition(all asbestos must be properly removed and disposed of prior to demolition) Waiting 3 ing Period Fee Not owner-occupied,single-family residence 3 Days $250 2. U 10-2591n ft and/or 48-159 sq ft asbestos R ,_': t'7= $500 CITY OF SPOKANE VALLEY 10 Days 3. U 260-9991n ft and/or 160-4,999 sq ft asbestos MAR 1�009 10 Days � $1,250 4. U >_ 1,000 In ft and/or>_5,000 sq ft asbestos Days 250* I H J 5. '= All Demolition - 2114i Additional categories U I have completed and attached the Supplemental Notice of Inrenh az(O l)for emergency,alternate asbestos project work practices, demolition with nonfriable asbestos roofmg,or exception fo ditions. * The$250 demolition fee is waived if demolition is performed in conjuctionrelatewith seasbestos (r st name&oject gory x number2, or 4,and/ore. mailing address): H. Optional:List additional parties you would like copies of this NOI and/or eness contained in this notificaf n and any •pl �!,tal information provided is,to the Com OI complete ete Review I r I certify offy that the informationedge, n �� lrnowled a accurate and complete. tom" ��1 U NOI deficient- best my g l ached i Fax Phone: V k 't , •,1 Business Name: IS Ilk ,.J,• Mailing Ada - evil?_ Print Name: S a� A:envy Use On! Signature: I � � � — 0--i..,,,.riPa„ Air 1101 W.College,Suite 403,Spokane,WA 99201 /1www,spokri ed,nonreefundable fees,isreceived by SRCSAA.NOT 11/08 Untitled Page Page 1 of 2 General/Specialty Contractor A business registered as a construction contractor with L&tI to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name ADVANCED UBI No. 602393166 EARTHWORKS INC Phone 5092164944 Status ACTIVE Address PO BOX 473 License No. ADVANEI950K6 Suite/Apt. License Type CONSTRUCTION CONTRACTOR City GREENACRES Effective Date 5/26/2005 State WA Expiration Date 5/26/2009 Zip 99016 Suspend Date County SPOKANE Previous License Business Type Corporation Next License Parent Associated Company License Specialty 1 EXCAVATION/GRADING Specialty 2 UNUSED Business Owner Information Name Role Effective Date Expiration Date PATTERSON, JEROD PRESIDENT 05/26/2005 Bond Information Bond Bond Effective Expiration Cancel Impaired Bond Received Bond Company Account Date Date Date Date Amount Date Name Number DEVELOPERS Until 1 SURETY &r 546994C 05/26/2005 Cancelled $6,000.00 05/26/2005 INDEM CO Insurance Information Insurance Company Policy Effective Expiration Cancel Impaired Amount Received Name Number Date Date Date Date Date OHIO CAS 4 53636043 05/26/200805/26/2009 $1,000,000.0005/21/2008 INS CO OHIO CAS https://fortress.wa.gov/lni/bbip/Detail.aspx?License=ADVANEI950K6 3/13/2009 6002/£I/£ 9.)I0S6IHNVAQV=asuaaqzxdse•1T 4aQ/dTgq/Tui/no5•um•ssa.1TJoJ//:sduq dll SOOZ/9Z/SO 00'000`00ES 900Z/9Z/SOSOOZ/9Z/S0 V99964766 NOONO1 vJld OD 900Z/SZ/SO 00'000`000`65 LOOZ/9Z/S0 900Z/9Z/S0 9ZSSt6S901 SNI SVJ Z DI1N`hlld LOOZ/S6/SO 00'000`000`65 800Z/9Z/S0 LOOZ/9Z/S0 EI09E9ES O0 SNI E . . ZJO Z aged aged papt2un 69 • -- - tS2 OZ set / RECEIVED BY CITY OF SPOKANE VALLEY MAR 13 2009 k't 1 L BY:, MIATAM 1_4 "jril clkOe We\/\- S RECEIVED BY CITY OF SPOKANE VALLEY MAR 13 2009 eh j lo7EEH tatAWL' 4-'�,, w w£0 http//slrlus/mox52/index cfm?action mox52_if frameset f t r X --.s:„-,--,4--...-1,4,-.sx a.. s m<P r q f,"girt -k 't,.-01,,,,..,,o `� .. 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