2010, 12-20 Permit App: 10004093 Demolitionsets
Si�i\t
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenterOsookanevalley.org
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS: ''f 5 23 E. • -741‘
ASSESSORS PARCEL NO.: 3.52.3z . 3 g to
BUILDING OWNER NAME: $INQ a 2,Ataz j + .1-1 pot Pe-rY
MAILING ADDRESS: Q CO2.8 3 ARRY 2 (a 2 E• .33 l
CITY: S PQk STATE: 1 J R ZIP: ! 2 23
CONTACT PERSON NAME: G \ P.'' s-ra6-1 l.F.rV _
PHONE: 5b1—l►315-'f1%"7 FAX: 316 (4i %r% CELL: EtY1-q$1-ai(oq
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
ow.se R
g .S,R r"1C
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
PROJECT DESCRIPTION (Please Provide Site Sketch)
Site Plan Provided 0 Notice of Intent #
❑ Spokane County Utilities has approved the disconnection
Describe the scone of work in detail _!_
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DDSCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit ss for construction or on a dwelling, the dwelling ;s/will
3e 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 perrnit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or aoditlonal
information may be requiret• •e submittsubs quently -pproved before this application can be processed.
Signature
Method of payment: 0 Cash Check :Visa
Bankcard #: EXP:
Date:
1
2 1 0 10
0 Mastercard
VIN#:
Authorized Signature:
Effective October 28, 2007 Page 1 of 1
P:\Community Developmer..t\02 Administration \03 Forms - Official Versions\Permit Center\Demolition Permit App
10.28.07,doc
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12/88/2818 14:40 5099283933
IRS ENVIRLNMENTAL PAGE 03/06
Spokane Regional Clean Air Agency - Print NO1 Page 1 of 2
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Customer Information
Company:
/ Owner:
Contact:
IRS Environmental et WA, Inc.
IRS Enviranmantol WA, Inc.
Rob Read
Email: SEYEbeirag.0yP.4•Com
Phone: 509-927-7867
Address: PO 8014 15215
Spokane Valley, WA 99215
Licensed Asbestos YES
Abatement Contractor:
Demolition Contractor: NO
/ ProDlrcy Owner. NO
Other:
NOT Information
IDN:IM: 2010-0427
Protect Type: Not owner-accupled, single-family residence + 260 - 999 In ft orasbestos
/•
removal and/or 160 - 4,999 sq ft of asbestos removal + all demolldon
Additional Info:
Pee: $500.00 (PAID)
Property Owner: nm Petty
509-535-5504
2662 E 33rd
Spokane, WA 99223
4523 E 7th Ave
Spokane
Gary Stoniay
509-961.21.59
,Site Atltlrce! 1:
/ SIM contact:
Multiple Structures:
Asbestos Survey:
YES
u.. .... .., e..,.t-...e.deene:r nrnMrint nni nsn7id„'674&.temp]etc=false
12/8/2010
WpKANE COUNTY HEALTH DEPAQTME
Division of Sanitafion ''ll' 3 O
1127 W. Malbn Avenue:.'�•
Spokane 11. Wazhmgtan -r...
Dye
% DATE_. •f! a• •
• APPLICATION .FO t PERMIT TO: INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES.:
`Hama
Address of Proposed Site..:. _ fifes o[ prbgarty--�
Type of IIsa _—a __ .:
.. �.�.i(» ?K--_.. Other ...•- -
le property below grade of streeta ar alleys!... : Are streets graded inf._ _
.:Di balementfor adding planaett _ . __ How cinch excavation on 811 propesedT _
Watmr Supply-_:. //rte T/ry'aya11 Spring)
Septic tank-eapactty _ St,.Q'.. ___-:gale. ¢tyle.9f tauLp _,.. _
. _. .. ; ..:wsarssse��--• -..
'! C/oe .11.111.!".1. -
(1) pray in.-pia➢ertt aroa:to scale.'
, (2) -Shoot relative location of: Propoiled1: cruse, se nk,
disposalheld, weU. garage,'. andother odt balldIDgk` i
ta) Make note Of anyheavy' elope or swampy area or any
other itaporfant topographic details.
Date when lest bole will be ready' for
bate lnstaltatfon will be ready for final .inspection (that'.is,
before backfying) _,... ......,__ '
SANITARIAN'S REPORT--'AND.-RECOMMENDATIONS; :"
stair inabectlith
Sop. CuddltjO .. _ _ _ ._Parcotatlod-festa Mlvuteec�-- ---- �.
..: 'Final inspection Date.: -d9
hECOMMENDED PEUMIT'$E' _
•
lroni84e--ivanh21/iM-alb)
H&R Complete Septic Services
P.O. Bos 749
Newman Lake, WA 99025
PH: 599.224-9955
PK: 509-922-4100
SD To •
BARRY, BARE
2662 E. 33RD AVE
SPOKANE. WA 99229
INVOICE
Job IGWEon
509.487.5500
W/C 4523 E. 7TH
SEPTIC PUMPING
TANK ABANDONMENT
Item Code
Ceic dpfon
Noe Each
Amount
750 GALLON
PUMPED 750 GALLON SEPTIC TANK
+SEPTIC TANK PUMPED POR TANK ABANDONMENT.
+THANK YOU!
245.00
• 245.00T
CLaome egrets to pity all legal action, Moray enc collection foes, agency Sees and
chargee. IS% intertat due aSR 30 days.
Subtotal 5245.00
Sales Tax (8.7%) ¶21.32
Total 522
PLEASE PAY BY
INVOICE.
Balance Due ¶266.32
on •r♦ nTn7w/TT