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2005, 03-21 Permit App 05000841 Demo Barn, 2 BldgsProject Number: 05000841 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: DEMOLISH BARN AND 2 OUT BUILDINGS Contact: LARSON'S DEMOLITION Address: PO BOX 4535 C - S - Z: SPOKANE, WA 99202 Setbacks: Front Left: Right Rear: Phone: (509) 535-7944 Group Name - Site Information: Project Name: Plat Key: 000000 Name: RANGE Date: 03/21/2005 Page 1 of 2 District: East Parcel Number: 55073.1548 Block: SiteAddress: 17503 E MISSION AVE Location:: CSV Zoning: UNKN Unknown Water District: Area: 9.56 Acres Nbr of Bldgs: 0 Review Information: Permits: Width: 0 Nbr of Dwellings: 0 Contractor: LARSON'S DEMOLITION INC Address: PO BOX 4535 SPOKANE WA 99220 Item Description STATE SURCHARGE ACCESSORY TO Lot: Owner: Name: ROOKS. ROBERT Address: 7141 N AUDUBON DR SPOKANE, WA 99208-4516 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Demolition Permit Firm: LARSON'S DEMOLITION INC Phone: (509) 535-7944 Units Unit Desc 1 SELECT 3 NUMBER OF Fee Amount $4.50 $60.00 Permit Total Fees: $64.50 Operator: DMD Printed By: MT Print Date: 03/21/2005 Project Number: 05000841 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit SCAPCA REGULATIONS MUST BE MET. DD Payment Summary: Permit Type Demolition Permit Date: 03/21/2005 Page 2 of 2 Fee Amount Invoice Amount Amount Paid Amount Owina $64.50 $64.50 $0.00 $64.50 $64.50 $64.50 $0.00 $64.50 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: DMD Printed By: MT Print Date: 03/21/2005 Mar 03 05 O2:54p Larsons Demolition Inc 509 535 8087 p.3 02-2B-05 02:45PMA FROM-SCAPCA 5054768Z8 T-BZ5 P.01/01 F-T55 A/rrattes: bemofiuw Contractor: Males RECEIVED =AMANCIttn sPc .ANECOMMaroU ttarcnrr al.Aurnoarnr ;a � C " �CQ6 t lei woe CoilgR&MO403. SODfs WA mat o NOTICE OF'JflENT Woo Tors: 5 POKA) E CZD 17Y A!R IA. PmkOMbp= II. 1..1Atoms Ra ni jtt1AalsametRaasralt7lasnif s I�,< '�----5�": sere. — -r.•.:: �ab Istrealy threes Robert Rooks q s� Repeal* Sac At: 17503 E. t t I Crie: ca3a es boa OA Caged Pence Jeff Tars= JobSitet'x�0i6 A tit AibatmSsrngsr I Pba1 509 994-3935 0 Pain Pe � Y,);rtfmseAsa Sena luaed? � SAteSunoy Na. ots an= AURA Buldptg ]!s U+ S[Nq Asa Sena Cpds** 2/21/QS ! Onaltaa ra i 3 I. -..... Nam . . t�dtkaeai[ Mather 35o3-04-23_02 t 1M/05 Na of anclura teen �^r mebake) 1i4t. [ Wks Day*:tm 1i T M A F Sa Sat M'i911 Sii was. asbestos he moved dab 0 Ya WEI nark aahadats L4Yes Lex' ppeatpdgor ep . b msat )byeeviaaareabdoa9 Oleo lax oa . bed' 17 No bercareed epewit sa a'mabsnas ewe Abeam Cantor Man Address i i _ I I Pre i 1 : IZi: (see beetle ] 3 1 Dar 3/03/05 0 a `(fibres adsoDrat des Onict) aaor[,etea) tkmeti6as Wads on of Oechr) Ian's tStdlti�, rbarneiL9 53�7944 t'#C 509 riariarasalS P.O. T3719Si5 riy_ >' s Ylaal rVratCakpeies: Ned&'sino I.LO.araeK,pkA_xasowa pcmoydseP,yoct• MatlecPamd 2. Deber� pa Lab weia aval • li iorNotke 34. U lO f 4s ara�- /91ssipp Esa(ta +i a far codas) 3 s s13D% 4.Li t.aae Ileafriar )f0-rg9q fort 10Das 9t799 Vane An ar= -d9.999 As 5750 6 . inpap knee faitet>Seam Nark lO S75Q 7. �r-megPse.YAvseueaaP7viattar is Notice ou StS03 8.❑� (dmn, aeCaeeafl+.acs: �7iW°°al�dswneo�a+osraanH ! Fmk er T�ePtoiaPa 9 Altar ton«CaestaestatHouaiable Aatrstm ltasewn nD k�s casettSersetw r)l;rio3 Trice Pmienbea Fos rase cmgaia i GA MIPbraly to awm.xaetial. a adoimttf mud' aaa moat seas neaa jfeit roe Twice as. Fos carten 4eater onabedCora Mi ad s edt at"p4rsawlddaW b ono ark eta ens the papaw tab le a., afie I R- QYaartac -0 aa' •rdom0ieaa..L. Fvpoldaadpa.n5CAPC4A l )ir74777, paths Mt =Da aft Nei aWsalsae■iaaMEMO (44aS &me wubaad/:Maieaas6scY IL leaner dttte oast+6ratathis asiflorlaa mod .ysappk data Jcf��,`r'l� 'exiard a erovLtrd ts. m the beat Isms l�/U1�1 - itiJ _ Ia�ss's I1�.eei;n :Its roasts a� darreas as YaradsaoeonMdraidoaos+bdanbolds rbatsaxoptaed140c'nehadbttegailedIcaisreeairdbySCAPCA. ** Chart A - 4 slate feat Firted \55e1 MAR 03 2005 15:15 509 535 8087 PRGE.03