2006, 01-19 Permit App 06000144 Demo House, ShedBUILDING PERMIT APPLICATION WORKSHEET
Spokane Valley Comrnunity Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address:
23
$924--E Main
Assessor's Tax Parcel Number(s):
0144
Legal Description: Residential
Derroliticn Ii:ase/mod
PERMIT DESCRIPTION:
❑ Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNERIAPPLICANT INFORMATION
jxj Owner: Mark Pce±s 0 Applicant art
Phone: 926-7511 Fax: 926-6115 Phone: Fax:
Address: 103 N. Icxiist - Address:
Spdcare Valley VA 99206
State Tip Code
City State Zip Code C�`
❑x Contractor_ i s Daroliticn, Irr. ❑ Architect
Phone: 535-7944 Fax 535-8087 Phone: Fax:
Address: P.O. Ea< 4535
City
Address:
State �77Zp Code City State Tip Code
WA State Contractor License #: LARSCall 64 u Contact_ Jeff Tarsal 994-3995
PER€ IITBUILD€NG INFORMATION
HEIGHT TO PEAK
DIMENSIONS:
# OF STORIES
MAIN FLOOR TO SQ_ FTG
2""j" FLOOR SQ. FTG: -
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECKICOV_ PATIO SQ_ FTG:
OCCUPANCY GROUP:-
- CONSTRUCTION TYPE
HEAT SOURCE
# OF BEDROOMS:
TOTAL HABITABLE SPACE
IMPERVIOUS SURFACE AREA
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON -SITE SEPTIC
SYSTEM?
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash
Bankcard #:
Authorized Signature:
❑ Check
❑ Mastercard
❑ VISA
Expires:
❑ Other
VIN#: - -
01/17/2006 10:52 5095351B93 e
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NOTICE OF INTENT
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suppurate data praviaed is, to ma hen
n contained en this notification and any step
t I of
that the " sod complete.
of my kn•;I;%,agars
Aepre,iss°g
red NO iaetudmg required Sus, is received by SCAPCA.
copy .. eeasbestrA stay,
periodycn i begin when a co — lr on at a0 times at the job site. col Hies
A eEd,c ssbau+c smrtb. committed emificntiaa & all amendments must bit available for inspection
PACE 01
Compressors Review
ZNOE cotnlllete
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RECEIVED 12.2245 18:52
FROM-5D88s51883
TO-SCAPCA
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01/17/2006 10:52 5095351893 C
111-13-08 13:24 FROM-SCAPCA
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PAGE 02/02
5094776028 T-298 P.01/03 F-986
CEIGTSBOS-NOke a1:00 on--@t-t0 l3A13)3M
Arm. y use only
Cast No.. p6_ Oo0
Am( raiment l:o.:
SPOKANE COUNTY AIRt POLLUTION
CONTROL t.UTHORITY
11 O1 W. College. Rile C 03, Spocana. WA 99201
Phone. (ST9) 477-472", Fax (S09) 477-6828
NOTIFICATION AMENDMENT
Agency U�sc Only
,
JAM a 3 200E
f
am,_ Date Received
8y A rRESTOS PRO TECT .EiMOLITION PROJECT
-- ,.[sot ornew:,usInflInISTWOR r.T--
Con ratter: there. a .at+e
Owner/CEO:
/s4 4,oer
Mail MMr S3: /. ✓ / j 4 Alone:6A9 'e — /J /S
ie vc _ start Ha z,.: 2/ Fax: e s3,s /n 3
ALL &MENs.. inns ADQvn s A no nr, mccta-r eieftc s -.. ;DIME CHANCES POO. OONTHACCOeS CAwTIC[CAT11Yti IN T9
WOE: K SCR) DLitt PAX PROGRAM. THE FEE MUST BY 4.7?ACME* TO EACH' AMENDMENT. ANY AMENDMENT TIL
CAA (GEE TUE PROJECT TWE OR PROJECT CATEGORY I. SMELT TO THE NEW NOTW®ICATION PERIOD. FOR A!
AMY gnaw.: • WIIBBS TOTS Intoner TYPE OR PROJECT CATEGORY IS ASSOCIATED "MN A STORM PVL A WEE EQUAL 1
THE OWFPER!-NCE BETWEEN THE FEE ASSOCCATE7) WIT$ THE MOST mtmern L.Y SV$Mn a nu NQTLPtcATaON AND Tut Fl
ASS( MATES WITH THE INCREASED PROJECT TYPE OR PRO. £CT CATEGORY SIMM- BY SomMITTED IN ADDTCION TO TI
2so A MENDM Clef FEE.
PLE ABE E) (TER CURRENT NOTIFICATION !NM;MATT JN BELOW:
AOS ICY CA: C 0: 06 —Cole LaPROIECt CATSGO tv r/ CANTRa['TOR San 6
IOU : cm Arm mess: a /� re°04Nr
MI ASE El 4TER AMENDMENT CHANGES BELOW •
® PR' ,SECT TYPE:
EZI„at.101 SITE ADDRESS:
DPidOLCi1ON STARTING HATE a
tram E STRUCTURE PROJECT (Aetecl map, site address ss, type and amount of asbestos material & work schedule)
❑ . sm PPI'sECr STARTING DATE: COMPLETION DATE:
❑ ' JEw WC RIC SCHEDULE DAYS: M T W TH F SA SU; WORK SHIFT HOUR&
®aD12171C NAL QUANTLTY TO DE REMOVED; SQNnite TT LINEAR PT
(NFW FOOTAGE TOTALS:,,,,- SQ JAI! FT LNEAR FT)
® "7EW TY .E OF MATERIAL TO BE REMOYSD (PI PARE INCLUDE 7222 QUANTITY FOR EACH TYPE):
.ows.....
.DDTTIC `L INFORMATION (ATTACH ADDITIONAL SHE? T IF NECESSARY),;
? 1
l DO I�>_-�::.A FY THAT THE INFORMATI ON COSTA) YES Y IRIS APPLICATION AND SUPPLEMENTAL DATA
RIBED HEREINM. TO TN£ REST OP MY 1:NOWLEDGE, ACCURATE AND COMPLETE.
SIGNATURE�,�. �,e
CON' RACTOR: JAr�yy f .��Ai131,
TELE 'MON$ )1134. ^� eh0.- e-
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