2013, 06-10 Permit App: BLD-2013-1054 Demolitionn0713p :24p
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Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 686-0036
Fax: (509) 688-0037
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(Staff Use Only)
PERMIT NUMBER: /
PERMITTEE: & 4&ao
DEMOLITION PERMIT APPLICATION
PROSECT ADDRESS: S J 1 qI & S)'n Ave
ASSESSORS PARCEL NO.:
BUILDING OWNER NAME:
MAILING ADDRESS:
cm: Spokane
STATE: WA
up: 99202
CONTACT PERSON NAME: Jay Torgerson
PHONE: 534-2970 FAX; 534-9404
CELL:
CONTRACTOR NAME: Rob's Demolition
MAILING ADDRESS: 3810 E Boone Ave #203
cm: Spokane
STATE: WA
up: 99202
PHONE: 5344970
FAX: 534-9404 CELL:
coNTRAcroR LICENSE No.: ROSSD197DRR
E:wIRES:12122/2013
CITY BUSINESS LICENSE NO.: 602343577
PSDESCRIPTION (Please Provide Site Sket h)
Site Plan Provided Notice of Intent # 201-5— D 1 gt-i
Spokane County Utilities has approved the disconnection
Describe the scope of work In detail '-
VeMD I c S i•F c- ft 7 bu g -e -
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
Spolcane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spolcane 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 and subsequently approved before this application can be processed.
Signature
Method of payment: 0 Cash 0 Check
Bankcard #: REDACTED
Authorized Signature: 1-3
'isa 0 Mastercard
EXP: REDACTED
REDACTED
01
This document originally contained
confidential credit card information which
was redacted pursuant to RCW 19.255.010
and the original document destroyed
pursuant to SOS DAN G52014-030.
Effective October 28, 2007 Page 1 of 1
P:\Community Development\02 Administration \03 Forms - Official Versions\Permit Center\Demolition Permit App
10.28.07.doc
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Spokane Regional Clean Air Agency - Print NOI
Company:
Owner:
Contact:
Email:
Phone:
Address:
Licensed Asbestos
Abatement Contractor:
Demolition Contractor:
Property Owner:
Other:
IDNt1M:
Project Type:
Additional Info:
Fee:
Property Owner:
Site Address 1:
Site Address 2:
Site Contact:
Multiple Structures:
Asbestos Survey:
Specialty Environmental
Norm Thomson
Norm Thomson
509-535-1313
2626 E. Trent Aye.
Spokane, WA 99202
YES
NO
NO
5095349404
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Page 1 of 2
2013-0184
Not owner -occupied, single-family residence + all demolition
$250.00 (NOT PAID)
WA State Dept of Transportation
324-6091
2714 N Mayfair
spokane, wa 99207
5119 E 5th -house
spokane
5119 E 5th -shed
spokane
Keith Preston
999-5293
2
YES
https://www.spokanecleanair.org/print_noi.asp?id=1882R.tetnplate=false 6/3/2013
Jun 0713 03:24p Rob's Demolition 5095349404 p.4
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Spokane Regional Clean Air Agency -Print NOS Page 2 of 2
Material Presumed: NO
Asbestos Found: NO
Survey Date: 11/30/2012
Inspector: Dean Smith
WA DOT
tt BIR -12-0S1
Project Dates: -
Structure
Quantity Type
Removal By:
Removal Completed: N/A
Materials:
Contractor:
Demolition Structures: 2
Demolition Date: 6/10/2013
Demolition Byt Demolition Contractor
Robs demo
Job 4.
928-0483
3810 E Boone
spokane, wa 99202
Fire Damage: NO
Emergency:
Alternate:
Alt asbestos to be removed by project completion: N/A
NOY Submit Date: 5/31/2013 3:32:15 PM
https:i/www. spokanecleanair.orglprint_Doi. asp7id=1882&templ ate—false 6/3/2013
Jun 0713 03:24p
Rob's Demolition
SPOKANE COUNTY UTILITIES
PERMIT
Application Number. SW -13000945
5095349404
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Permit Issued Date: 06107/2013
Expiration Date: 06/07/2014
Project Description:
Project Name:
Primary Contact
Phone:
SEWER ABANDONMENT
CARNAHAN
ROB'S DEMOLITION
509-534-2970
Applicant ROB'S DEMOLITION
Address:
3810 E BOONE AVE #203
SPOKANE, WA 99202
Ph one: 509-534-2970
Email: jey.robs@gmail.com
SITE INFORMATION•
Ste Address: 5119 E 5TH AVE
Parcel Number. 35231.1236
Assessor's Description: CAROLINE W 5FT OF LT 4; E SOFT LT 5; LT 6;
EXC W 216.5FT BLK 2; EXC HWY
Inspection Area: : (509)-477-3675
Zoning: •
Owner:
Address:
Phone:
Email:
STATE OF WASHINGTON -DOT
2714 N MAYFAIR ST
SPOKANE, WA 99207-2090
Water District Camhope Irrigation District Flre Dlstrlct Spokane Valley Fire
#7
Lend Area: 11182 Square Feet
CONTRACTOR INFORMATION-
ROBSDDI97ORR, Exp. 12/22/2013
ROB'S DEMOLITION
3810 E BOONE AVE #203 SPOKANE, WA 99202
509-534-2970
jay.robs@gmall.com
DETAILS.
Class
Type
Quantity Unit Charge Value
SEWER ABANDONMENT
FEE DETAIL.
Processing - Utilities
Utilities Permit
Total Fee:
$26.32
$125.00
$151.32
1 5125.00 1125.00
$125.00
CONDITIONS'
Possible FEMA Flood Zone
Inside Public Transit Benefit Area
Plan review tee is required for all site plan reviews conducted by Spokane Valley Fire.
CALL 1-600-4245555 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.
SEWER PERMITS ARE VALID FOR ONE (1) YEAR FROM THE DATE OF ISSUANCE. FOR SEWER INSPECTIONS CALL THE UTILITIES
DEPT AT (509) 477-3604 FROM 5:30.5:00 MONDAY -FRIDAY PRIOR TO COVER. ONE WORKING DAY NOTICE REQUIRED. PERMIT
ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL INSPECTION FEES APPLY AFTER 30 MINUTES.
Date Printed: 06!07/2013 11:04:50 Project Coordinator: Kathy Cummings