2009, 10-21 Permit App 09003430 Demo House Community Development Department (Staff Use Only)
Permit Center
SCITY OF 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER: 111
pokane Spokane Valley, WA 99206 �_;
Tel: (509) 688-0036 PERMIT FEE: .�
Valley® Fax: (509) 688-0037
permitcenterCalspokanevallev.org
DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS: -7j0 /Vt G\./2i2c1201,1 c kc i3O I ,2ih0e0
ASSESSORS PARCEL NO.: y SI l.1 3 t-j 2,3
BUILDING OWNER NAME: Si el.[i1A- P�i2Q0•117
MAILING ADDRESS:
CITY: STATE: ZIP:
CONTACT PERSON NAME:
PHONE: FAX: CELL:
CONTRACTOR NAME: ROB'S DEMOLITION INC
MAILING ADDRESS:3810 E BOONE AVE#203
CITY:SPOKANE STATE:WA Zip:99202
PHONE:534-2970 FAx:534-9404 CELL:
CONTRACTOR LICENSE NO.:ROBSDD197ORR EXPIRES:12/22/09 CITY BUSINESS
LICENSE No.:602343577
PROJECT DESCRIPTION (Please Provide Site Sketch �-�9�
—
Site Plan Provided Notice of Intent # v03� 3
Spokane County Utilities has approved the disconnection
Describe the scope of work in detail
Oewto (tSi!it �n
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
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 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 s-- Date: 1012-1 1c5
Method of payment: ❑ Cash ❑ Check ®Visa ❑ Mastercard
Bankcard # - EXP:04/12
VIN#:
Authorized Signature: This docu ent on i ��`
T g�+y- -contained---- 0,4
confidential credit card information which jc
was redacted pursuant to RCW 19.255.010 iD
and the original document destroyed
pursuant to SOS DAN GS2014-030.
Fffertivp flrtnhar 7R. 7nn7 Perna 1 of 1
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Gmail - County Sewer Disconnect? - 3 Sites Near Evergreen& Broadway Page 1 of 2
GyiJay Torgerson <jay.robs@gmail.com>
byi:,tosk. BETA. •
County Sewer Disconnect? - 3 Sites Near Evergreen &
Broadway
4 messages
Jay Torgerson <jay.robs@gmail.com> Mon, Jun 29, 2009 at 2:16 PM
To: Roger Rivers <rrivers@spokanecounty.org>
Hi Roger,
We're planning to do a demolition job near the southeast corner of Broadway & Evergreen --more specifically
at:
13904 E Broadway Ave--45143.1426
13916 E Broadway Ave--45143.1427
710 N Evergreen aka 13901 E Springfield —45143.1423
Do we need to get sewer disconnect permits from the County for this job?
Thank you,
Jay Torgerson
Rob's Demolition
509-534-2970 phone
509-534-9404 fax
Rivers, Roger<RRivers@spokanecounty.org> Tue, Jun 30, 2009 at 3:45 PM
To: Jay Torgerson <jay.robs@gmail.com>
Cc: Permit Center<permitcenter@spokanevalley.org>, "York, Louis" <LYork@spokanecounty.org>, "White,
David" <DWHITE@spokanecounty.org>, "Urhausen, Billy" <BUrhausen@spokanecounty.org>
Jay,
As per our records, none of the subject properties are connected to the Spokane County Sewer System.
Therefore, a sewer abandonment permit and inspection by the Spokane County Division of Utilities IS NOT
REQUIRED.
Roger Rivers
Customer Service Representative, Spokane County Division of Utilities
PS: F.Y.I. I will be on vacation from July 7th thru July 13th.
Roger
From: Jay Torgerson [mailto:iay.robs@omail.com]
Sent: Monday, June 29, 2009 2:17 PM
To: Rivers, Roger
Subject: County Sewer Disconnect? - 3 Sites Near Evergreen & Broadway
[Quoted text hidden]
Jay Torgerson <jay.robs@gmail.com> Tue,Jun 30, 2009 at 3:55 PM
http://mail.google.com/mail/?ui=2&ik=b301101 e97&view=pt&search=inbox&th=1222de... 6/30/2009
Oct 12 2009 10: 53RM PHALON ABATEMENT 509-928 8785 P 1
6LOct. 7 2009 �1 46PM,M SPOKANE,CLEAN AIRiENr SOS-928-eN�...1543 P. 1
P- 1
Notice of Intent No. iti( ) ( L O f' I T ll.I 1 f
•;;.• 11)I: , .I;1 ,111•, I'I!<)11 1 \ .)I .II It la 41,
frerunv ___h Aires
[iRefer to the Acettey'a Aeaovation,Demolition,and �etosi Informal •�8 w" . ' �• 'i' • ,_• •cte IX
A. Project Type: ❑Asbestos Removal Aebestos Remove!&Demolition . ❑Deme)Itttan,No Asbestos Renteval
Don this project involve a Ilse-damaged structure?: • 0 Yes In No (Ifyes,refer to Sections 9.03Y,3 and 9.08)
Does thisproJect involve demolition by fire training,: ❑Yes ili No (See Sections 9.02.R.9.03.AA&9.04.A.6,t) '
How many contiguous structures does this project involve?(5 1 (Hamm than 1 shucdue,refer to Section 9.04,A.3)
max):
B. Property Owner: 11.4i41 V ,fey FilkofteceSteN Phone:'�I'ZIS 7e3g„, Pax:
MaiUag Address: 10 )�.�?Oot SD C PARK _City: �,c10106,4tle f State: LA I Lip: (N2 in,
C. Site Address: 10 . (e 13 Ci : Ko nt State, tea rip: (a
Ccolaot Person ictf K. /Ate,he S46A42.7 Job Silo Phone;
a. NI Asbestos&lrrvey or `Dato survey performod, 7-$i- 09 IAHERA Bldg,:Inspector Name: Ke.V 1 W M Q CS I s J1
0 Material Preowned Wes asbestos an Ycs 0 No Cornpeny: I
1 M Cart.No.: Bl
found? •tJ/,ob 6
• Asbatoa Removal *Start Completion Abatement By T—
llatomtatlent Dates lair j 19 Date: tO-22`t)9 (if known): j ra4k1.43ta)43ATervvEtat
List individual Inland ijtt4. EVell:ARee64 ^460 Sly floccitbI'1tE$/lt'11C.si�.ti't�!cissatit�t°inter als to be 1 1. ei et E.8R4,•Dt,)IW . i 10 gF gt4cinytt
b
removed.if>1 tallithim,list
materiels for each streetaue !Total Linear Fool; l ITotal Square Feet: I Sip
by oddities f laprtioo. Will all ethos/Gs material be removed from the strum re(s)6v t project completion?®Yes ❑No
F. Demolition Start Demolition By
Inforruatient Date: 'Q_23. c? (If known);
G. Asbestos Project and Demolition Notification Wafting Period and Non.RelundaMe Fee Categorizes
You addvuce aotifeallon period will begirt when a,outplety4 NOI,including required nonrefundable foes, is received by SRCAA.
A.,,,„.. .,,11,1,`•t. •,,,:0,, 1.uu,71 I.....1u1,c ,'.ce tl)c 14'1,,,,: ,uu ,rh'pl.,..a\ .V.1.,<t.•s'h)11'. ,Iucti \1 l.lu)•2 I'r...•tl r,
I.❑ a 10 In fl and/or 48 sq fl asbestos project not perfor led by residing owner Prior Notice SO
2.0 All Demolition(all asbestos must be property removed and disposed of prior to demolition) 3 Days S30
3.❑ 10-259 In fl and/or 48-159 sq It asbestos 3 Deys 5250
4. gi 260.999 In R and/or 16D-4,999 sq it asbestos 10 Days p) •
5. ❑ L 1.000 le It and/or 2 5,000 sq R aebastos • 10 Days S1,250
6.❑ A71 Demolition 10 Days 5250*
e The$250 demolition fee is waived(f denroliffon is performed In conjunction with asbestos ppojecr eategnry 3, 4 or S.about.
Additional Categories Which Mey Apply to the Project Categories in I-6,Above
i .1,1..,E t'1'.,•,l .\a n-It:lt......l.. i t.
7.❑ Emergoaey Soction 9.04.A.b.h Prior Notice Twice the Regular Fee
Select the reason that best describes your situation:
Sudden,unexpected event that resulted In a nubile.health or saibiy hazard.
■ The project mustproccod ItmaodirNoly to protect equipment,easuro continuous vital utilities,or minimize property damage.
■ Mixable-containing metot'iale were encountered that were not identified during the asbestos eurvoy.
■ The • -•t mutt•rooeed to avoid Im.osin: en uor'sasonebie in• Dial burden.
\If,.,...I 1.1,.;,.• I'IOIt't'. \1/.11' I'''CI,'t? 1.'lo;i',,1 \\: i , I'.,1.,,1 \,.I, IG.1,•..1..1 I, I♦',•
Spokane Clean Air.3104 E.Auguste Avo,,Spoken;WA 99207/wwwvs enecicttneit.org(Ph:(509)477-4727 Pax: (509)477-68 09/09
•
'-/
Received Time Oct. 6. 2009 10:26AM No. 1506
Oct 12 2009 10: 53AM PHALON ABATEMENT 509-928-8785 P 2
Oct. 7. 2009 1:46PMjM SPOKANE CLEAN AIRENT 5o9-92e-te'N0..,1543 P. 2 p•2
t zut.li..0 h„ r11, 1rd u' ( .in,iitil:r.. Itlli•Iru.•t \\aitin•: Vol 'du 1-,C21unit 110k I ,.
9.❑ Exoeptioa for Hazardous Conditions Section 9.Oa.0 , 10 days Regular Fes
Name of person thatprepared the Alternate Work Plan:
Company he/she represents:
Hit/her eortItled ALEERA Project Designer No,:
His/her Certified Industrie,flygiontst(CIH)number or
Professional Engineer(PE)bemuse number:
),'I it I,,,r.l'.IIt.I�l'11 t1,:11,if t�,1•. .(/`. 16U111111:' It'I\'11111'c1 \\':IIIU.;2, Ill 1111(I 'v,l:-tt•:11111.1.1 :If I C•
10.❑ Demolition with Nonfriable Asbestos Roofing Section 9,08.8 10 day, Twice the Regular Fee
Name of person thm determined that nontkiable asbestos
loofirtg material could be loft in place per Scot,9.08.8:
Compen'heishe represents;
Iiisiher certified AHHRA Project Designer No.;
H. Optional:Um eddktonrl particr you would like copies of this NOI and/or related notices sent to(Ilan name da fax number srul/or rs&HM address):
1. Ack owledgeraent
Tho Control Officer.or duly authorized representative,shall be allowed to eccess property it reasonable rime.to inspect projects
specific to the control, recovery,or rolease of cunteminente into the atmosphere,in accordance with SRCAA Regulation I,Article II
and RCW 70.94.200, For the purposes of renovation,demolition,and a,beetos 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 orduly authorized representative are investigating air quality complaint,filed with agency and/or have
reason to believe that air quality viola/Iona have occurred or may be occurring.No person shall obstruct,hamper or interfere with any
suck inspocdoo, •
1 oertify that the information contained in this notification and any supplemental information provided is,to the bet of my knowledge,
accurate Ind comp tete.
Business Nan eli4Airit..1feSATEal Fax; 919 87%5 Phone: 92g SIfo'Sfa
Mailing Address:Flo. fit: It.B 5 10 a tx)A. c'tgT Z3
Signature: Print Name: Ti it S. ?h el,.kr0'
J. Agency f/.rc Only.
❑ NOI Deficient:
•
•
MNO1 Complete )Q‘a70/41,19}1t.1bE,�-
Page2of2
Spokane Cleiut Alr,3104 P,Augusta Ave., Spokane.WA 99207/www,spoksticcleanair.olg/P11:(309)477-0727 Fax:(509)477-6828 09/09
Receired Time Oct. 6. 2009 10:26AM No, 1506