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2007, 08-20 Permit App: 07003260 Demo Residence 0'7— 3ZA0 Permit Center SQTY of 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: pokane Spokane Valley,WA 99206Q . 1 PERMIT FEE: ®,jvalle . (509)688-0036 FAX: (509)688-0037 w w.spokanevalley.org Community Development Demolition Commercial Permit Application n Residential SITE ADDRESS: /Q Vo a -- ' a v e—/ c `i, o/ !/‘/Il7 cv�y- 972c'6 ASSESSORS PARCEL NO: /6—?d 1,. / 20 / Building Owner: y I Contractor: /t il Name: Z C7 /n Name: p e Address: `0 4, Z 6 vii Address: IP City:G,� 4,� val7Yy State:�,q.. Zip:9w4 City: State: Zip: Phone: , ,____ ?7e2,- Fax: Phone: Fax: _ Contractor Lic No: Exp Date: Contact PersonG/� ` /� City Business Lic.No: - Name: *// Phone: :'Y 9 703 Describe the scope of work in detailJ Q �� l , /D9aZ j VA o A site plan is provided. o Spokane County Utilities has approved the disconnection. o Notice of Intent# a 7 -- G 2.7 ZThe 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 development rights granted by any issued permit inure to the property owner. Signature 4i7 11,) --- Date 'r- D,C) -- G7 Method of Payment: ❑ Cash Check ❑ MasterCard ❑ VISA RECEIVED BY Bankcard #: Expires: VIN#: CITY OF SPOKANE VALLEY AUG 2 0 2007 Authorized Signature: REVISED2/16/07 PEi.' R R IAAA I . , NOI No. SPOKANE REGIONAL CLEAN AIR AGENCY u E QaehivYi IR 1101 West College,Suite 403,Spokane,WA 99201 O-7 02-/ l��'' NOTICE OF INTENToAUG 2 0 2007 Ag (NOI)TO ' AL A. Project Type: 1. Asbestos Removal 2. U Asbestos Removal&Demolition 3. i . ' . lf • � ova B. Property - 9 70y (If available) Owner: ,o yo z- e > Phone: a Fax: Property Owner's _ c t r p F Mailing Address: G f ty o«_ 5,4A1�"e t/'{ll0", City: SPOK Ke_ 1/YedeZ. State:W 4 Zip: � C. Site I'40 Z. e., c ,ra/l / e,-/y 0,,s- / — Address: ,- Address: City:S,nVK L/1d. ii‘4'y State:4(14 Zip: 7 2 Z°ro Responsible Site ke l(ti 2-i E '\ / Job Site Contact Person: Phone: ;9y 4 71- 7 D.a& Asbestos Survey or I survey performed,was asbestos found? Date SurveyNo. of Structures: U Material Presumed Yes LI If No,Attach Survey Conducted: 2' (see back if>1) 1 _ AHERA Building rnA'pK L.s � geci< Certification Exp. Inspector Name: Number: 07-©c 7 ] Date: l`"/5--oS E. Asbestos Project No. of Structures: Start Completion Wk.Days: Su M T W 00 Sa Information: (see back if>1 I Date: Z-16'07 Date: 8--/‘- 0 7 Hours: All 16 Total quantity qo WLn. ( -2 r.J� i, Sq. Will all asbestos material be 42 Yes Will work schedule LiYes to be removed: JFeet I yare'7Neet removed by project completion? U No fax pgm.be used? 0 No List individual type and quantity of materials to ce Ace e.. '. .._..1 S`A�............ .......... `<4..c......... ... ,c./...................................................................................................... ........... be removed or provide an attachment of same: s ..i..,GG p +r T 14.59 _,__. rm ; 6r,,,,fi /� Co41.ti- l-47,5- Abatement f Abatement Contractor: Phone: Fax: Mailing Address: City: State: Zip: F. Demolition No.of Structures: Start U Training Fire(List Fire Dept.as demo. contractor below) Information: (see back if> 1) Demolition t''t Date: U Ordered Demolition(attach copy of Order) ,/ VIP- Contractor: Phone2�`f' g7�3 Fax: Mailing e b' rT G`�`j ,,/� Address: �2 D y c p c*-� ✓4l`v City: 0/C„ n,c____W”' / State: Zip f'd ` 6 G. Asbestos/Demolition Project Categories: Notification Non-Refundable Does this project involve a fire-damaged structure? U Yes ® No Waiting Period Project Fee 1. ® Owner-Occupied Residential Asbestos Removal&Demolition Project* Prior Notice $30 ® Owner-Occupied Residential Demolition Project Only* 2. U All Other Demolitions With No Asbestos Removal Project 10 Days $250 3. U 10-259 linear feet or 48- 159 square feet(see back of form for options) 3 Days $250 4. U 260-999 linear feet or 160-4,999 square feet 10 Days . $500 5. U > 1,000 linear feet or>5,000 sq�e feet 10 Days $1,250 6.LI Emergency Asbestos Project or Emergency Demolition Project Prior Notice Twice Project Fee 7. U Alternate Means of Compliance for Friable Materials or U Demolition 10 Days Twice Project Fee 8. U Alternate Means of Compliance for Nonfriable Asbestos Materials 10 Days Twice Project Fee 9. U Exception for Hazardous Conditions Concurrent with Project Regular Project Fee * The two categories in G.1 apply only to owner-occupied, single-family residences,which means any non-multiple unit building containing living space that is currently occupied (prior to and after renovation/demolition) by one family who owns the property as their domicile. One of the categories in G.2-9 must be used for all other renovation/demolition projects.For more information,call(509)477-4727. H. Optional:List additional parties you would like copies of this NOI and/or related notices sent to(list name&fax number and/or mailing address): I. I certify that the information contained in this no • e tion and any supplemental data provided is,to the best Completeness Review of my , edge,accurate and complete. i ra( I complete ❑NOI deficient- � ' See ttache, 0 , , eV ign* • � // Representing I)•to J 2-� `-C7 ' Ag' cy Use Only 90 Your advance notif a io !.eriod will begin when a completed NOI,including required fees,is received. A copy of the asbestos survey,completed notification&all amendments must be available for inspection at all times at the job site. S:\FORMS-June 2007\Asbestos\Notice of Intent.doc / ( --- 136 _-------------- _,.. / \\: 101-jO7 Litt". auC4 t a.rce-C... # `f5 2 f 0( . 1`lo1 , 2 8, yo 54 /c"7- Le 7' _ r / O ("_ - - - -4 1, , I Irl N� nt' i I til, , 1 N (i\ \I IL-(Deo sr- iV • N moose4y 1 . IoyoZ iti t., i I . t ?'o gE rrb1171,6e, i,vioc.takek _____, i , \ 4 ki * i I " .....____ . . 1 __ ?tie-- / \ \., --- _: \\,_ aC 1-11"14 i 1 :14) ce- i 4 Sli gq---i. ni A Nt. _ . ., _ ____ _1_1_1_,_--