2008, 02-04 Permit App: 08000294 Demo Residence Permit Center
- 1tA
C1TY 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: ()Z
SpOaile Spokane Valley,WA 99206
ValleY. (509)688-0036 FAX: (509)688-0037 PERMIT FEE:
www.spokanevalley.org
Community Development
Demolition Commercial
Permit Application K. Residential
SITE ADDRESS: I LI Gj 1= 10 -n-i S c G \/i y
ASSESSORS PARCEL NO:
Building Owner: K' / vv\C. Contractor:
L
Name: Vs_.-
` (s/( V c t+.1 he /tel Name:
Address: iq Address: cK! .
City: State: "4 Zip t 0 Cityy6"0 Ki � , State: (,,3.t Zip:
Phone: , Fax: Phone: Fax:
-417225
Contractor Lic
Contact Person City Business Lic.No:
L
Name: S/>L
Phone: `sem-{ 2+"7 .. as3^?
Describe the scope of work in detail
O --t-e
A site plan is provided.
t1 Spokane County Utilities has approved the disconnection.
Notice of Intent# - 003 0
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 V�, Date 2- - ®g
Method of Payment:
❑ Cash ❑ Check ❑ MasterCard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 2/16/07
Feb 04 2008 11 : 44RM SPOKRNE#COUNTY#UTILITIES 4777178 p.2
FEE! 04 0006 10:2`3 FR bV FERMI-r GEN 1 ER 6880037 Ti] 4774715 F.02/133
Pettntt Center PER var rn aiacf.\
S __ 11703E Sprague Ave,Suite B-3 ��
011..
�` •
Spokane ValWl9920ey, p ;
(509)68S-0036 FAX (509)668-003
www.sookanevullev.org
Community Development
Demolition ❑ Commercial
Permit Application Residential
srrE ADDRESS: { 1 C o s E . (o - . S 910 G N L L4~ . (.2..)
ASSESSORS PARCEL NO: 4 5 Z3 3 , 0302
Balldltt` Naet:, .Contractor:
Nam" kvt(-1 Vi C V41 Ar-rcl Name: C rpZ �c,r-r vQ -
Addres" (44 `/br�C1-4.-1160( Adareu: c1 S. � st
Vert. .j State: L✓•d q?0.26 Ci o<Ne.is yr { Stitt'tti5\ ' 1
Phone: , - f moi / Pax. eyPhone: .2/7—007-2Fax: , , _,'742i3-`-.2E,/
+^ -w.2E,/
Contractor Lic NoGA VL mv,,kFzezep
Contact Person City Business Lie.No:
LName:S/}&IL ', r r p. — - mFfS 31 670 •
Phone: 5b1 2r7
Describe the scope of work in detail
e_'NJ CP-Ag- Ar,_•..r V__ V421,3
t�
..,164r•-i J. .1-,Art R .
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 permit or approval for any violation of federal,state or
local laws,codes or ordinances.
Ownership of resulting development ruts granted by any issued permit Inure to the property owner.
Signature /� — Date 2-11- d
Method of Payment:
❑ Cash ❑ Check 0 MasterCard 0 VISA
Bankcard#: Expires:
Authorized Signature:
Nemo&WO
•
wx TOTAL PR8E.03
FEB 04 2008 11:41 4777178 P8GE.02
' SRCAA NOI No. SPOKANE REGIONAL CLEAN AIR AGENCY(SRCAA) j Sat ReCetved I ' RCA ,S
1101 West College,Suite 403,Spokane,WA 99201 L))' L' - Lj
0 S - `0 0 3 0 NOTICE OF INTENT (NOI) `; JAN 3 2008 Li
Agency Use Only For Asbestos Projects and Demolition Projects Agency-Use Only !
A. Project Type: 1. Li Asbestos Removal2.fi Asbestos Removal&Demolition 3. U emolitio tint'; IAin 40:S removal
B. Property i i 5' -1;'i available)
Owner: 1�u 1(' (t d4 (L.(4v S Phone: ,z^ -1 _6(....4-5--- Fax:
Property Owner's Se'O/./.s.5-6/E •
Mailing Address: e , 14-4 '22 F_ . v! -L-L L•- City: LA)f>, State: 4/4- Zip: (:) 2,-
,
C. Site `f,, v/C
Address: ( C ,os 'F , (0 i City:SPO 1,j.(d fes. State: tom/P1-- Zip: ° .'O J 6
Responsible Site /Job Site ?�I
Contact Person: S Pcc/1_,.. S12 -( J Q--- Phone: -7/c/ J
D. arAsbestos Survey or Ifrvey erformed,was asbestos found? Date Survey No. of Structures:
Li Material Presumed CJ Yes U If"No"for any structure,attach survey Conducted:-(-.-2-C--(Dc (see back if>1)
AHERA Building Certification Exp _Zi_off
Inspector Name: ( W SenTe 44 Number: 17.- (Z - O 7 O Li c. Date:
E. Asbestos Project No. of Structures: Start Completion Wk.Days: Su Sa
Information: (see back if>1) Date: -2..._-c-( -OS' Date: 2- `7- - S Hours: Am • w,
Total quantityLn. Sq. Will all asbestos material be Utes Will work schedule Yes
L
to be removed: 1 Feet `/- Feet removed byproject completion? ❑ No fax pgm.be used? a'No
List individual type and quantity of materials to --( Li f..[ . T.,. S 1-1--1 ccs
be removed or provide an attachment of same: 4'
Abatement
Contractor: V"t V& cT C (WI ra,kL V-i `r4</kr.... Phone: `7q -Q 7'Y/ Fax: ?
Mailing
Address: p Q r. `-1 I ( (lc/`-f City:S\2c 1,< 1.12 State: (✓A- Zip:
F. Demolition No. of Structures: Start ❑ Training Fire(List Fire Dept.as demo.contractor below)
Information: (see back if> 1) \ Date---'- -O�r ❑ Ordered Demolition(attach copy of Order)
Demolition �j
Contractor: �/� (� 12 - ( T'-l-1 V Phone:7M-1-63( Fax:
Mailing 4-c,
Address: + kG.Z �e C/ City:S P314(141‘,_ State: l/4-- Zip:5'9 OSS
G. Asbestos/Demolition Project Categories: Notification Non-Refundable
Does this project involve a fire-damaged structure? ❑ Yes ❑ No' Waiting Period Project Fee
1. ❑ Owner-Occupied, Single-Family Residence Asbestos&Demolition Project*
Prior Notice $30
❑ Owner-Occupied,Single-Family Residence Demolition Project
2. ❑ 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 $2-50
4. ❑ 260-999 linear feet or 160-4,999 square feet 10 Days $500
5. U > 1,000 linear feet or>5,000 square feet 10 Days $1,250
6. ❑ Emergency Asbestos/Demolition Project(attach"owner's letter") Prior Notice Twice Project Fee
7. U Alternate Means of Compliance for Friable Materials(attach plan) 10 Days Twice Project Fee
8. ❑ Alternate Means of Compliance for Nonfriable Materials(attach plan) 10 Days Twice Project Fee
9. ❑ Exception for Hazardous Conditions(attach plan) Concurrent with Project Regular Project Fee
10. ❑ Demolition with Nonfriable Roofing Left in Place 10 Days Twice Project Fee
*The two categories in G.I 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 must be used for all other asbestos/demolition projects.For more information,contact SRCAA at(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):
C mpleteness Review
,NOI complete
I. I certify that the information contained in this notification and any supplemental data provided is,to the best of S❑
NOI deficient-
m wled:- .cc ra , and complete. See Attached
Signature`�-----...._ Representing Date n�
For demolition projects,this NOI expires 12 months from the earliest listed asbestos/demolition project start date.
Agency Use Only
Your advance notification period will begin when a completed NOI,including required fees,is received by SRCAA.
A copy of the asbestos survey,completed notification&all amendments must be available for inspection at all times at the job site. Not 7/07
SpOkane.0.00
Valle
11705 E Sprague Ave Suite B-3 ♦ Spokane Valley WA 99206
• 509.688.0036 ♦ Fax: 509.688.0037 •
Transmittal
Date: 2/4/2008
To: SPOKANE COUNTY UTILITIES
Fax: 509-477-4715
From: CSV PERMIT CENTER
Re: Review/Approval of Demolition Permit Application
Attn: Billy Urhausen
Roger Rivers
Glen Gredvig
Colin Depner
Lela Gallert
Request: DEMO SINGLE FAMILY RESIDENCE
SITE ADDRESS: 14605 E 10TH SPOKANE VALLEY,WA
PERMIT PURPOSE: DEMO RESIDENCE
Feb 04 2008 11 : 53RM SPOKRNE#COUNTY#UTILITIES 4777178 p• 1
, • .._.....„.....„
.000VaIley
11705 E Sprague Ave Suite 11-3•Spokane Valley WA 992
06
• 906.665.0036•Far 309.688.0037•
Transmittal
vow
Gats: 21412004
• SPOKANE COUNTY=HIES
Roc S03 4774715
CSV PERMIT CENTER
Rc Roview!Approval of Demolition Pait Application
°I'd <e '•
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\\\ iiri 1°11fA
ttn; Billy Urhaiisen45‘% tk\9� k
Roger Rivera •` ke 1,.
Glen Cred J , , �y r
Colin Depner I\ 5 k a A ,V► X44/
Lela Gellert 9°4
�( ,�
Request: DEMO SINGLE FAMILY RESIDENCE.i...5 p1,e-4444,
4 ‘ A-Ii.ii 09 tk
SITE ADDRESS: 14605 E 10111SPOKANE VAI,.LEY,WA 1,1 aix
�}5233. Cl,a2 ‘ •
PERMIT PURPOSE:DEMO RESIDENCE
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FEB 04 2008 11:49 4777178 PAGE.01
Feb 04 2008 11 : 44RM SPOKRNE#COUNTY#UTILITIES 4777178 p• 1
:FEB 04 2008 12:29 FR SU PERMIT CENTERMIT CENTER IU 47(471 r.elite
0.000"%44...4,
WKWan'
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11705 E Sprague Ave Suite 8-3•Spokane Valley WA 99206
•509.688.0036+Fax: 509.688.0037•
Transmittal
f; )
Date: 214/2008
SPOKANE COUNTY UTILITIES
Fax: 5004477.4715
CSV PERMIT CENTER
Re: Review/Approval of Demolition Permit Application
t#ttn: Billy Urhausen
Roger Rivers
Glen Gredvig
Colin Depner
Lela Galiert
Request: DEMO SINGLE FAMILY RESIDENCE
SITE ADDRESS: 14605E 10"SPOKANE VALLEY,WA
4.5233. 0,302
PERMIT PURPOSE:DEMO RESIDENCE
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FEB 04 2008 11:41 4777178 PAGE.03
Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2
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General/Specialty Contractor
IA business registered as a construction contractor with LLtI to perform construction work within the scope
lof its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance.
License Information
License SAULMMB922BP
Licensee Name SAUL M BREITHAUPT
Licensee Type CONSTRUCTION CONTRACTOR
601788801 Verify Workers Comp Premium
UBI Status
Ind. Ins. Account
Id
Business Type INDIVIDUAL
Address 1 C/O KATHLEEN TAYLOR
Address 2 LAKEVIEW LANDING
City BAYVIEW
County OUT OF STATE
State ID
Zip 83803
Phone 5097141331
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 1/17/2008
Expiration Date 1/17/2010
Suspend Date
Separation Date
Parent Company
Previous License HAMMEDI942MM
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License
https://fortress.wa.gov/lni/bbip/Detail.aspx?License=SAULMMB922BP 2/4/2008
Look Up a Contractor, Electrician or Plumber License Detail Page 2 of 2
Business Owner Information
Name Role Effective Date Expiration Date
BREITHAUPT, SAUL M OWNER 01/17/2008
Bond Information
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
PLATTE
RIVER INS Until
#1 CO 41132363 01/15/2008 Cancelled $12,000.00 01/17/2008
Savings Information
No Matching Information
Insurance Information
Company Policy Effective Expiration Cancel Impaired Received
Insurance Name Number Date Date Date Date Amount Date
MARYLAND
#1 CAS CO SCP03333077 01/15/2008 01/15/2009 $1,000,000.00 01/17/2008
Summons/Complaints Information
No Matching Information
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= 'i, 1-800-547-8367
skoo mins e,Washington State Dept.of Labor and Industries. Use of this site is subject to the laws of the :f8' C@5 '
state of Washington.
Access Agreement I Privacy and security statement I Intended use/external content policy I Visit access.wa.gov
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Look Up a Contractor, Electrician or Plumber License Detail Page 1 of 2
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Labor �In ustriesg -1
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Look Up a Contractor, Electrician or Plumber
Printer Friendly Version
General/Specialty Contractor
A business registered as a construction contractor with LFrI 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.
License Information
License HAMMEDI942MM
Licensee Name HAMMERHEAD DEMOLITION INC
Licensee Type CONSTRUCTION CONTRACTOR
602625975 Verify Workers Comp Premium
UBI Status
Ind. Ins. Account
Id
Business Type CORPORATION
Address 1 P 0 BOX 3156
Address 2
City SPOKANE
County SPOKANE
State WA
Zip 99220
Phone 5093280160
Status ACTIVE
Specialty 1 GENERAL
Specialty 2 UNUSED
Effective Date 7/14/2006
Expiration Date 7/14/2008
Suspend Date
Separation Date
Parent Company
Previous License
Next License SAULMMB922BP
Associated
License
https://fortress.wa.gov/lni/bbip/detail.aspx?License=HAMMEDI942MM 2/4/2008
Look Up a Contractor, Electrician or Plumber License Detail Page 2 of 2
•
Business Owner Information
Effective Expiration
Name Role Date Date
BREITHAUPT, MARK
P PRESIDENT 07/14/2006
BREITHAUPT,
AARON P SECRETARY 07/14/2006
BREITHAUPT,
AARON P TREASURER 07/14/2006
BREITHAUPT, SAUL VICE
M PRESIDENT 07/14/2006
Bond Information
No Matching Information
Savings Information
Bank Assignment
Bank Branch of Savings Effective Release Assignment Impaired Received
Savings Name Location Number Date Date Type Date Amount Date
2110 N
INLAND RUBY ST
NW SPOKANE Until
#1 BANK WA 9920 47015752 07/13/2006 Released Bond $12,000.00 7/14/2006
Insurance Information
Company Policy Effective Expiration Cancel Impaired Received
Insurance Name Number Date Date Date Date Amount Date
SCOTTSDALE
#2 INS CO CLS1298109 03/22/2007 03/22/2008 $1,000,000.00 06/06/2007
SCOTTSDALE
#1 INS CO 2184819 07/13/2006 07/13/2007 $1,000,000.00 07/14/2006
Summons/Complaints Information
Tax
Summons/ Cause Warrant Complaint Complaint Judgment Judgment Payment
Complaint Number Id Plaintiff County Date Amount Date Amount Date
STAR
RENTALS
Et SALES
#1 072011191 INC SPOKANE 03/19/2007 $2,436.50 04/26/2007 $3,329.25 06/12/2007
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_. . About LalFind a job at LEtI � Informacion en espanol I Site Feedback
thmetetwe ofutocto 1-800-547-8367op
wournut$
m Washington State Det of Labor and Industries. Use of this site is subject to the laws of the
state of Washington.
Access Agreement I Privacy and security statement I Intended use/external content policy I Visit access.wa.gov
Staff only link
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