2006, 04-28 Permit App 06001609 Demo 2 BldgsSpolkane
.„ Valley
Permit Center
11707 E Sprague Ave, Sure
Spokane Valley, WA 99
(509)688-0036 FAX: (5
Community Development www.spokanevallev.ore
Residential Construction
Permit Application
-0037
D1 APR 2 2006
(c-n
1
PERMIT NUMBER: & Cn
I PERMIT FEE:
1 IT owTci 'u ' ❑ Accessory Bldg
❑ Addition/Remodel ` DDeck
j Other: 't-, o vt.
SITE ADDRESS / f g
ASSESSORS PARCEL NO:
LEGAL DESCRIPTION:
Building Owner:
. .
Name: Cd� 0i5e-LL-.
/'max `S CCC
Address: f 7
City: 5 Jc _
State: J, Zip: 7 ao)
Iv
Phone: 3c.,,_' t y If!
Fax: S-3 (. i t s 7
Contact Person
Name: a)ec_
Phone:
Contractor:
Name:
5A-v-1i___VC;\-4--,V
Address: ? fo
l Gay
City: jP c�
State: L.A _ Zix-
Phone: 5 3 b, L
L pr
Fax: 53 y l 5—`7
C.otract��ic
2c it.3
Exp Date: a.. `6--)
City Business Lic. No:
Describe the scope of work in detail: i Cost of Project: $
<5 V- Cr> -t— �i c.%s !� JC271 r5° Tzv 6
*************The followinMUST be complete: (write N/A if not applicabli) *********************
HEIGHT TO PEAK:
Xe-) f
DIMENSIONS:
..*')X 't.) ._ /ate ^
# OF STORIES:
%
TOTAL HABITABLE SPACE:
Cam)
MAIN FLOOR TO SQ.
FTG: �COi� `�,-
2Nu FLOOR SQ. FTG:
icf LLA0G�g. ,
UNFIN BASEMENT SQ. FTG:
ti ,,.r[
IMPERVIOUS SURFACE
AREA: `s
FINISHED BASEMENT
SQ. FTG: /VIC-
GARAGES . FTG:
DECK/COV. PATIO SQ. FTG:
, -) -
30% SLOPES ON
PROPERTY: �
# OF BEDRO MS:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This 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
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 8/25/2005.M1
❑ Check
❑ Mastercard
Expires:
Date
VISA
VIN#:
doarst
4.0.00Vfey
11707 E Sprague Ave Suite 106 ♦ Spokane Valley WA 99206
509.921.1000 ♦ Fax: 509.921.1008 ♦ dtyhall@spokanevalley.org
Residential Plan Submittal Minimums
O Completed Building & Mechanical application with: Accurate address, Parcel
Number and/or Legal Description, description of work, owner and contractor
information, signature, and date.
❑ Two sets of plans including Site Plan, elevations, floor plans, foundation plans
With details, roof plan, framing plans & details.
❑ Show the height of any proposed buildings or accessory structures.
❑ Floor plan for each floor. Dimension to scale (minimum 1/8") and label each
Room (including sq. footage of house and garage on plans) Show each
level of existing house and square footage of any additions.
❑ All braced wall panel types: show locations and details of installation, including
engineered design.
❑ Egress windows: Provide at least one window or exterior door approved for
Emergency escape or rescue from a basement and in every room for sleeping.
❑ Smoke detector locations
❑ 22" X 30" attic access location
D 18' X 24" crawl space access:
❑ One -hour separation detail: between house and garage
❑ Floor framing details: Joist type, size, spacing and installation details
o Roof framing plan and details
❑ Fumace and hot water heater location.
❑ All header locations: type, size, and connections
❑ Foundation plan
❑ Insulation information
'04-25-06 09:38
FROM-SCAPCA
5094776828
T-532 P.01/01 F-301
(� f0 t
�—/ `�✓ [geaq Use r `
1101 West College, Sgitc 403 SppaakanC WA 99201
NOTICE OF`I!Y"PENT
(NO!) TO FERPORM:
APR 2 2006
. • Ag?+cy UraO4
A. Project Type:
1. 1UAsbeswos Removal
Z. LI Asbestos Removal & Demolition
3. II D
Na h.shoRtag estmnval
11
B. Property L.
Owner: �e (LEiyv4.pL.e,i
pbon4: 53‘ ISM
(If available)
Fax: V-Not %lel
Property Owner's t�
Mailing Address:-.. 3\ 0 5 as%,c,
!
City 617A tcca.n e
&ate: u.30.
Zip: cRzoa.
C. Site
Address: 4 s �z £`. M
`� .n
City: LXa (Cane-
stater A.
zip:9'nn
nZa
Responsible Sire Job Sin:
Contact Person: � 12 2, %?LL _, Pbvac: ' S' i'$ t S
D. U Asbestos Survey or 1 If survey_periermed, was asbestos Pound? 1 Date Surrey ANo. of Structures:0 Material Presumed f 0 Yes If No. Attach Survey tt4uath ' 4 (.0j isee back if>1) C._
AHRRA Building
Inspector Name:—CjYt+) S. P�'1cdap4
Certificaticl 1Ettp•
Number % F� --Ca-era% Dann\z4ek,
E. Asbestos Project
Information:
No. of Structures: /
.(scc back if71) i�/6—
Start
Dare:
Completion
Data
Wk. Days: 3u M T W Th P Sa
Hours:
Total quantity
to be removed:
La.
Feet
Sq.
. Feet
Will all asbestos material be LI Yes
removed by project completion? ❑ No
Will work schedule U Yes
fax pgni. be used? 0 Tin
List individual type and quantity of materials to
he removed or provide an anaahment of same: _
Abatement
Contractor. Pliaion Abatement Services, Inc.
Phone: 92r3 S&55
Fax: 925 S7fs5
Mailing D.O. Eosc• 30968
Address:
Ci ty$pcskano
Stau.WA
pg223
zip
F. Demolition
Information:
No. of Sfitctwes: Z
(see back it> 1)
Start
Date: s'•�` bEo
U Training Fire (List Fire
CI Ordered Demolition (atmob
Dept as demo. contractor below)
copy of Order)
Demolition
Contractor. CAM `C a C.erSstmCAON, f-•
Phone: rmfo is t$
Fax: 53i. €sis'7
Mailing
Address: E. ' IOS tj(1U/t
��}}
City: ghee
State: IAA s
Zip: %`4R02.
1. AsbestostDcmolitionProject Categories:
Does this project involvo a Ere -damaged structure? 0 Yes 0 No
Notification
Waiting Pejiod
Non-liefindable
Project Fee
1. LI Owaor-Occupied Residential Asbestos Removal Re,flemniirinn Project'`
0- Owner -Occupied Residential Demolition Project Only •
Prior Notice
S25 ry
2. IN All Other Danolitions With No Asbestos Removal Project
i0 Days
3. U .10 - 259 linear feet or 4a • I59 square feet (see back of form cur ciptIoas)
3 Days
SISO
4.1a 260 - 999 linear feet or )60 - 4,999.square feet
10 Days
r S300
S. LI 1.000-.9.999 linear feet of 5010 - 49,999 sgnare fbet-
10 Days
S750
6. Li > 10,000 linear feet or> 50.000 square feet
10 Days
$1,500
7, LI Emerkeeney Asbestos Project or t-1 Finiergency Demolition Project
Prior Notice
Twice Project Fez
2, L[Alternate Meares of Compliance or Ikiable itmerials or 13 I)etnalision
10 Days
Twice Protect Fee
9. Li Alternate Means of compliant* for Nonfriable Asbestos 110002/s
10 Days
Twice Protect Pee
10. Li Exemption for Hazardous Conditions
Concurrent with Project
Regular Project Fee
up
t building containing living
• The two categories in O.I apply only to our -Occupied. single-family residences. which means any rmn-muldplc
space that is Currently occupied (prior to and after rencvaricn%damaiition) by one family who owns the properly as their domicile, One of the
eato3nrie< in C..2 9 jm,st be uScd far all other renovation/demolition projects. Far more information, contact SCAPCA at (509) 477-4727.
- optional: LIR additional ponies you would liim copies of this NOr and/or related nodcee eerie to (liar name St fax numoar antvor mailing address):
I ' . that th
. . owl •,
t.
L 'r► �----
information contained in this notification and any supplemental data provided is, to
accurate and complete
Ni4th A l3T 5�"f iuea 4zAda
the best
pletemas Review
NQI complete
'U NOLdsflcknt -
a
Mac
S1p w:ure Repnnnling
Jr advance notifimliun period will begin when a completed NOI, including required fees, is received by $CAPCA.
opy of the asbestossurvey, completed notification & all amendments mnst be available for inspection at ett times at the job situ. Not 12t05
RECEIVED 04-24-06 11:0T FROM-5099288785
coo -01
TO-SCAPCA
PAGE 02
PHALON ABATEMENT SERVICES, INC.
P.O. Box 30968 • Spokane, WA 99223 • Office (509) 928-8656 • FAX (509) 928-8785
CAMCO Construction, Inc.
3105 E. Boone
Spokane, WA. 99202
ATTN: Mr. Lee Campbell
24 APRIL 2006
RE: 4912 E. 9th Wood Shed & Metal Building
Asbestos Survey
Dear Lee,
On 4/20/06 we performed a asbestos survey of the wood shed and metal building to identify
suspect building materials that would be disturbed during demolition.
Wood Shed ( East Edge of Property )
The only suspect building material located on the shed is the asphalt type sheet roofing.
Sample Number 1WS Roofing was examined at Mountain Laboratories and was found negative
for asbestos.
Metal Building ( West Edge of Property )
Metal type pole building with wood framing and fiberglass insulation.
No suspect building materials were identified in this building.
We have enclosed the Laboratory's Bulk Sample Analysis sheet for your files and please provide
a copy of this letter and sample results to your project supervisor.
Please advise your work crew to contact there supervisor if they encounter any other suspect
building materials at the site and to refrain from disturbing that material until it is identified.
Respectfully,
Tim S. Phalon
EPA Certified Asbestos Building Inspector No. BIR-05-061
Certification Expires Sept. 26, 2006.
PAS
PHALON ABATEMENT SERVICES, INC.
P.O. Box 30968 • Spokane, WA 99223 • Office (509) 928.8656 • FAX (509) 928-8785
4912> PE
lRestoe sce. To RCwt&tom
No S..is\ic j
\,vaoD
5MD
No ACM
04-25-06 08:17 FROM-SCAPCA
1-529 P.01/01 F-295
O0Agert rheU 1
'oh
NO `ICEarOFI INTEWA NT
`VI
(NO1) TO PERFORM:
APR 2 4 2006
. Agency Were?,
A. Project Type: 1. Cl Asbestos Removal
2.1..1 Asbestos Removal & Dnnolition F 3. NI Den�li)� Na�sstansmotal
B. Property ( 1
Owner: lee (LA cast Let\
phone: S3io 1 81 B
(If available)_
Fax: a P, Vel
Property Owner's f�
Mailing Address: l._ E. 5% (5 S a&%n
City: 683 ker n a
State: LO A
Zip: g9Z02-
C. Site
Address: Lket12e�, I;- `�[H
I City: 5POGcLrje.
State:. . 7
at
Zip:c1-lzlZ,
Respanslble Stte
Contact Person: _Lee C
Sob 5trc ,5rt 1S Thom-
D. • Asbestos Survey or
Cl Material Presumed
Ifsurvey rformed, was asbestos found?
0 Yes •IfNo. Attach Survey
Date Sur rcy �.((
Conducted: `t aZO' G
No. of Structures:
(see back if>1)Z.
AHF.RA Building
Inspector Name: -TWYY) S. Phak
Certification,,Fxp.
Number. ne%—CiS-Se% Date:gtZO,Cfo
E. AsbestoS Project
Information:
NO. of Structures: /
•(scc back if>1) Ci"
Start Completion
Date: Date:
Wk. Days: Su M T W Th F Sa
Hours:
Total quantity
to be removed:
Ln.
Peet
Sq.
Feet
Will all obese,: material be Ti Yes
removed by project completion? 0 No
Will work schedule LI'Yes
fax pan. be used? 0 No
List individual type and quantity of materials to
be removed or provide an attachment of same:
AbaContractor
Contractor. Phalon Abatement Services, Inc.
Phone: 9Z8 8656
928 t57b5
Fax:
Mailing 3 B
Address: P.O.Box 0968
ci tygpokane
WA
Srate.
_9
ZI221
F. Demolition
Information:
No. of Structures:
(see back It> I) C.
Start
Date: "j-O(o
_
Li Training Fire (List Fire Dept. as demo.
0 Ordered Demolition (atraoh copy ofOrdor)
contractor below)
Demolition -y-
Contractor: CAMctli COnsta ►Ltmta1 164C-
Phone: 51 1$ IS
Fax: Sib 91S1
Mailing
Address: e, , .-10 S f'� cove
`•
city: b eC C.S- L
State: tom A
Zip.: g9202
G. Asbestos/Demolition Project Categories:
Does this project involve a fire -damaged structure? L1 Yes ❑ No
Notification
Waiting Period
Non-Ketundable
Project Fee
1. LI Owner -Occupied Residential Asbestos Removal k l)e snlitinn Project *
❑ Owner -Occupied Residential Demolition Project Only
PrlorNotiee
S25
2. • All Other Demolitions With No Asbestos Removal Project
10 Days
3. 1.1 '.10 - 259 linear feet or 48 - IS9 square feet (see back of faun fur options)
3 Days
S150
4. Li 260 - 999 linear feet or 160 - 4,999.square fat
10 Days
S300
5.1a 1.000 - 9,999 linear feet or 5,000 - 49,999 square feet
10 Days
$750
6. Li s 10,000 linear feet or > 50,000 square feet
IO Days
S1 500
7_ U Emergency Asbestos Project or I -I Emergency Demolitio.ntojeer
Prior Notice
Twice Project Fee
S. ITAloernste Means of Complianca for Friable Materials or Uperttolirion
10 Days
Twice Project Fee
9. L1 Alternate Means of Compliance for Nonfriable Asbestos; Materials
10 Days
Twice Project Fee
10. 0 Exception for Hazardous Conditions Concurrent with Project Regular Project Fee
* The two eategorita in. O.1 apply only TO owner -occupied. sinelo-famib' residences. which means any non -multiple un s building containing living
space that is currently occupied (prior to and alter renovation/demolition) by one family who owns the property es their domicile. One of the
raregnriec in 6,2.9 must be used for all other renovation/demolition projects. For more information, contact SCAPCA et (509) 477-4727,
H. Optional: List additional panics you would like ;epics of this NOT and/or related notices sent to (list name & fax number and/or mailing address):
that th information contained in this notification and any supplemental data provided':, to the best
w1 •._e, accurate and complete.
Srgrawre
Qt414teW $c Il elan telly teb 4644
Representing Mac
S'Cyom�npletcncss Review
'8 N0I complete
CI NOLdoficient -
G0 d
AzenotIJJ-
MUr advance notification pciiod will begin when a completed NOI, including required fees, is received by $CAPCA.
copy of the asbestos survey, completed notification & all amendments must be available for inspection at all tithes at the job she. NoiI2/05
RECEIVED 04-24-06 11;07 FROM-6099288T86
TO-SCAPCA
PAGE 02
;Mountain Laboratories
Division of Mountain Inspection & Laboratory Services, Inc.
9922 East Montgomery Suite 13
Spokane Valley, WA 99206
(509) 922-1365 • Fax (509) 922-1380
Phalon Abatement Services
Tim Phalon
PO Box 30968
Spokane, WA 99223
Dear Mr. Phalon:
NVLAP CAB CODE ID 101890-0
April 20, 2006
Project Name: 4912 E. 9th
Project#: Wood Shed
The enclosed report details results for the analysis of the bulk sample (s) submitted to Mountain
Laboratories on April 20, 2006. Mountain Laboratories participates in a National Voluntary
Laboratory Accreditation Program (NVLAP) for Bulk Asbestos Analysis, governed by the National
Institute for Standards and Technology (NIST)-NVLAP I.D. #101890-0. Sample results must not be
used by the client to claim endorsement by NVLAP nor any agency of the United States government.
Sample analysis was performed to determine asbestos type and content using Polarized Light
Microscopy, supplemented by Dispersion Staining (PLM/DS) in accordance with the following
methodologies:
USEPA Test Methods EPA/600/R-93/116 "Method for the Determination of
Asbestos in Bulk Building Materials"
ASTM Draft "Standard Method for Asbestos Containing Materials by Polarized
Light Microscopy" (Committee D22.05, January 14, 1988)
This report includes a summary of the analytical results, chain of custody and copies of the analysts
report forms used by our analysis. Analytical results are only reflective of the samples, which were
tested and presented in this report. Mountain Laboratories limits warranty to proper analysis methods
and take no responsibility for sample procurement.
It has been our pleasure providing you with these analytical services. If you have any questions
regarding t s report, please do not hesitate to call me or Heidi McCarthy at (509) 922-1365.
Sincere
aren L. Dradr
aboratory Manager
Mountain Laboratories
Mountain Inspection & Laboratory Services, Inc.
Enclosure: 4005.4758
Polarized Light Microscopy, NVLAP Accreditation • Phase Contrast Microscopy, PAT Participant
BULK SAMPLE ANALYSIS FOR ASBESTOS
Phalon Abatement Services
Tim Phalon
PO Box 30968
Spokane, WA 99223
Method: PLM With Dispersion Stainin
Project Name: 4912 E. 9th
Project#: Wood Shed
Client # 4005
Laboratory No.
B06-4758
Sample ID No.
1 WS
Sample Description
Roofing
Sample Treatment
Teased/Dissolved
Homogeneous
Yes
Layered
No
Fibrous
Yes
Sample Color
Black
Asbestos Present
No
Asbestos Type and
Percentage
1. Chrysotile
2. Amosite
3. Crocidolite
4. Other
N.D.
Total % Asbestos
None
Other fibrous material
In sample
Cellulose 54%
Synthetic 30%
Non -Fibrous Material:
Aggregate <1%
Tar 15%
Date Analyzed: April 20. 2006
Analyzed By: Heidi L. McCarthy
Mountain Laboratories, Division of Mountain Inspection & Laboratory Services, Inc. warranty to proper analysis methods only and takes no responsibility for sample
procurement. Mountain Laboratories, Division of Mountain inspection & Laboratory Services. Inc, 9922 E. Montgomery, Suite 413, Spokane Washington 99206 (509) 922-1365
- Fax (509) 922-1380. PLM has been known to miss asbestos in a small percentage of samples. Thus negative or <t % PLM results should be tested with either SEM or TEM.
Client is responsible for sample separation. This report may only be reproduced in full with written approval by Mountain Laboratories.
2of2
Mountain Laboratories
9922 E. Montgomery, Suite 13
Spokane, Washington 99206
PHONE 509-922-1365
FAX 509-924-1380
2005
Billing Information:
Check/Cash
Credit Card #
Credit Card Expiration Date:
To Be Billed
CHAIN OF CUSTODY RECORD
Client / Company
cam.. 0O..
Project No. ) da P 5 i-l*p
Project Name 1 Z C . 9 1 J4
Results MAIL
12 cg7oS
PHONE
CLIENT:
ANALYSIS REQUIRED
TURNAROUND
# OF CONTA[NERS
!PLM - BULK
PCM - AIR (N!OSH 7400)
LEAD -AIR, PAINT, WIPE
RESULTS
RUSH 48 HR
12 HR 3 DAY
24 HR 5 DAY
REMARKS
SAMPLE #
SAMPLE DESCRIPTION / ID
DATE /
TIME
.1. ors
)90oPi,ry
(;Joan_) sHeD
no c4 eSffS
c+t LfirIcCii.40/
C)4 --Q') --C o
RELEASED Y:
i i.
%(sa ur
DELIVERY
METHOD
RECEIVED BY:
(SIGNATURE)
COMPANY / AGENCY OR AFFILIATIONRECEIVED
DATE / TIME
CONDITION
1 t
11:N
4 /Jp1
Mountain Laboratories
4-1aj. - l .'OCR
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