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2010, 03-17 Permit App: 10000727 Demolition
Permit Center ✓ an re 11703 E Sprague Ave, Suite B-3 Spokane, Spokane Valley, WA 99206 p�7 (509)688-0036 FAX: (509)688-0037 4000 "J • www.spokanevallev.org Community Development Demolition Permit Application PERMIT NUMBER: 16-‘5.FEE: n Commercial n Residential SITE ADDRESS: 216 2 E - ASSESSORS PARCEL NO: till ing t �r`4$x09... ., s3. t: 22 JN r:-,,. Name: $F„c� 5 , Name: �_ Address:AD.°7 (4.)SrE4nKG,1 Address: City: s0Aevte_ StateLd A_ Zip:922or City: State: Zip: Phone: / yr/ 313 8t,'3 Fax: Phone: Fax: Contractor Lic No: Exp Date: It n Pekeit., . ;:, , „3 City Business Lic. No: ` Name: 5 -r ve- . Phone: (n 7S/- 3/3 -goo; 11u5- 0tkCO Describe the scope of work in detail Ovk 13 .11 / ha.,.Jvj 1t00w o A site plan is provided. o Spokane County Utilities has approved the disconnection. o Notice of Intent # The 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 Method of Payment: ❑ Cash Bankcard #: Authorized Signature: ❑ Check REVISED 2/16/07 Date 3 - / 7 - /d ❑ MasterCard Expires: ❑ VISA VIN#: r w J 0 7102 E 9th AVE - SITE PLAN ' = 20" +/– Q H 0 ee / \ / COLEMAN EXISTING POWER a b EXISTING WATER I I MAIN 32' EXISTINGI RESIDENCE 517 SF —EXISTING GAS • 15' SET BACK I i - MAIN y 3 I to z F ADD TION 486 SF m rn w � I io fv 27' 11' 12' y� 1 EXISTING GARAGE 240 SF EXISTING DRIVEWAY. 5 SET BACK to 140' j 7102 E 9th AVE - SITE PLAN ' = 20" +/– Q H 0 ee /.../ ', NOTICE OF INTENT p EC©EEdVI—) MAR 1 7 2010 Notice of Intent No. Spokane pRe tonal �v FOR ASBESTOS PROJECTS /UE\iOLLI10N SPOKANE REGIONAL CLEAN AIR AGENCY Agency Use Only Clean P.irg .,. Date Stamp - Agency use Only Refer to the Agency's Renovation, Demolition, and Asbestos Information Sheet as well as Regulation I, Article DC A. Project Type: ❑ Asbestos Removal ❑ Asbestos Removal & Demolition ,Demolition, No Asbestos Removal Does this project involve a fire -damaged structure?: ❑ Yes,21No (If yes, refer to Sections 9.032.3 and 9.08) • Does this project involve demolition by fee training?: ❑ Yes J 'No (See Sections 9.02 R, 9.032.4 & 9.04.A.6.f) How many contiguous max): structures does this project involve? (5 �q r� (If more than 1 structure, refer to Section 9.04.A.3) 3/3 80033 R. Property Owner: S%crr. SwwK f Zn //2 2; .- 507 9'di/'A//a5 !Phone: City: 5DA-^-t- II State- 'goo? 4./L Zip: ?nig- Mailing Address: o' S/an-•-N- C. Site Address: 7/02. E 9 City:1ol....._ vada,. State: 1, 4Zip: 9.9 ttt_ Contact Person: 3/-&-e- 1•1 Job Site Phone: / FC-! J/) Fro 3 D. Survey or Date survey performed: 3-/S-/0 AHERA Bldg. Inspector Name: 'I"'� ( 117 cr4 EAsbestos age reji,. Cert.No.: Material Presumed Was asbestos found? • Yes Z'No Company. ,as$�5taS 0 271 / E. Asbestos Removal Information: Start Date: Completion Date: Abatement By (if known): List individual kw and quantity of materials o be removed. If>1 structure, list for Total Linear Feet: Total Square Feet: materials each structure by address / location. Will all asbestos material be removed from the structure(s) by project completion? ❑ Yes ❑ No F. Demolition Information: Start Date: (earliest) 5 _20— /0 Demolition By (ifknown): s/-ri. -x - S G. Asbestos Project and Demolition Notification Waiting Period and Non -Refundable Fee Categories Your notification will begin when a comoleted NOI including required nonrefundable fees, is received by SRCAA. advance period Owner -occupied, single-family residence (see the Renovation, Demo, & Asbestos info. sheet) Wailing Period Fee i.■ 210 In ft and/or 248 sq ft asbestos project not performed by residing owner Prior Notice $0 aril All Demolition (all asbestos must be properly removed and disposed of prior to demolition) 3 Days $30 Not owner -occupied, single-family residence Waiting Period Fee 3. • 10-259 In ft and/or 48-159 sq ft asbestos 3 Days $250 4. ❑ 260-999 In ft and/or 160-4,999 sq ft asbestos 10 Days $500 5. • 21,000 In ft and/or 25,000 sq ft asbestos 10 Days $1,250 6. • All Demolition 10 Days $250' 'The $2S0 demolition fee u waived ifdemohdon is performed in conjunction with asbestos project category 3, 4 or 5 b , aove. Additional Categories Which May Apply to the Project Categories in 1-6, Above 7. 0 Emergency Section 9.04A.6.h Twice the Regular Fee Select the reason that best describes your situation: ❑ Sudden, unexpected event that resulted in a public health or safety hazard. ❑ The project must proceed immediately to protect equipment, ensure continuous vital utilities, or minimize property damage. ❑ Asbestos -containing materials were encountered that were not identified during the asbestos survey. ❑ The project must proceed to avoid imposing an unreasonable financial burden. Alternate Asbestos Project Work Practices Reference Wilting Period Non -Refundable Fee 8. 0 Alternate Asbestos Project Work Practices Section 9.08.A 10 days Twice the Regular Fee Page 1 oft Spokane Clean Air, 3104 E. Augusta Ave., Spokane, WA 99207 / www.sookanecleanainore / Ph:(509)477-4727 Fax: (509) 477-6828 09/09 Exception for Hazardous Conditions 9. ❑ Exception for Harardous Conditions Reference Waiting Period Non-xtefiadat' Pee Section 9.08.0 0 days Regu ar Pee Name of person that prepared the Alternate Work Plan: Company he/she represents: His/her certified AHERA Project Designer No.: His/her Certified Industrial Hygienist (CIH) number or Professional Engineer (PE) license number. Page 2 oft Spokane Clean Air, 3104 E. Augusta Ave., Spokane, WA 99207 / www.sookaneeleanair.org / Ph:(509)477-4727 Fax: (509) 477-6828 09/09 Demolition with NonfriableA.cbestos Routing 10. • Demolition with Nonfriable Asbestos Roofing Reference W;'siting Period Non -Refundable Fee Section 9.08.8 10 days Twice the Regular Fee Name of person that determined that nonfriable asbestos roofing material could be left in place per Sect. 9.08.B: Company he/she represents: His/her certified AHERA Project Designer No.: H. Optional: List additional parties you would like copies of this NOl ando related notices sent to (list name & fax number and/or mailing address): 1. Aclmowledgement The Control Officer, or duly authorized representative, shall be allowed to access property at reasonable times to inspect projects specific to the control, recovery, or release of contaminants into the atmosphere, in accordance with SRCAA Regulation I, Article R and RCW 70.94.200. For the purposes of renovation, demolition, and asbestos projects, reasonable times include, but are not limited to, any of the following: when renovation, demolition, or asbestos removal appear to be occurring or are scheduled to occur, and times when the Control Officer or duly authorized representative are investigating air quality complaints filed with agency and/or have reason to believe that air quality violations have occurred or may be occurring. No person shall obstruct, hamper or interfere with any such inspection. I certify that the information contained in this notification and any supplemental information provided is, to the best of my Imowledge, accurate and complete. Business Name: Ca. -`Fax: Phone: Mailing Addrs: 1( `— Name: cv Signature: Print J. Agency Use Only. 0 NOI Deficient: -11-e ntt II ii t dives; + s/ k ,c(dvuf a de Fidy.wrj c u ... . .. ii..c k o ttc . V4 .. it- CS 065 Fre . —(t(c/ IV NOI Complete 5 / I1-17.41 10 Oj IL & Initial Page 2 oft Spokane Clean Air, 3104 E. Augusta Ave., Spokane, WA 99207 / www.sookaneeleanair.org / Ph:(509)477-4727 Fax: (509) 477-6828 09/09