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1995, 09-22 Permit: 95007565 - Refund Duplicate PermitOiJNreDrii Ri1GIENT'OF BUILDINGS WEsr 1026 BROADWAY • SPOKANE, WA 99260 -0050 ' (509) 456 -3675 SITE INFORMATION PROJECT INFORMATION SITE ADDRESS: 2916 S AVALON RD SPOKANE WA 99206 PARCEL NUMBER: 45274.0704 SUBDIVISION: MOUNTAIN VIEW 4TH ADD LOT: 5 BLOCK: 7 ZONE: UR -3.5 INSPECTOR: FRANK PALADICHUK WATER DIST: OWNER: ANDERSON, GAYLE PHONE: 509 927 0506 ADDRESS: 2916 S AVALON RD SPOKANE WA 99206 PROJECT NUMBER: 95007565 ISSUE DATE=: 09/22/95 PERMIT USE: SEWER CONNECTION - MT VIEW (95S -870) APPLICANT: ARMSTRONG CONSTRUCTI PHONE: 509 928 0559 ADDRESS: PO BOX 14282 SPOKANE WA 99214 CONTACT: DICK ARMSTRONG PHONE: 509 928 0559 SETBACKS -> FRONT: N/A LEFT: N/A RIGHT: N/A REAR: N/A LENDER NAME: PHONE: ADDRESS: SEWER PERMIT PERMIT(S) CONTRACTOR ARMSTRONG CONSTRUCTION LICENSE #: ARMSTC *192N1 ;EWER CONNECTION 'ROCESSING FEE OTAL PERMIT FEE 1 10.00 $50.00 PAYMENT SUMMARY AYMENT DATE RECEIPT# PAYMENT AMOUNT 09/22/95 00008982 TOTAL FEES AMOUNT PAID $50.00 $50.00 AMOUNT OWING S50.00 S.00 ;'SUED PERMIT BY: BURRIS, ROBIN NOTEs ** *FOR SEWER STUB AS -BUILT INFORMATION AND INSPECTIONS, CALL THE COUNTY UTILITIES DEPARTMENT AT 456- 3604 * ** CONTRACTOR OR APPLICANT IS TO FIELD LOCATE AND CONFIRM THE ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER EXCAVATION TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT. CALL BEFORE YOU DIG (456 -8000) SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE THAT THEY ARE CLEAR AND UNOBSTRUCTED TO THE SEWER MAIN * CALL FOR INSPECTION PRIOR TO COVER * * * * * ***** 24 HOUR NOTICE REQUIRED 09 -27 -95 02:18 PM FROM H &S CONSTRUCTION 1 SPOKANE COUNTY DEPARTMENT OF BUILDINGS WEST 1026 BROADWAY • SPOKANE, WA 99260 -0050 (509) 456 -3675 STYE INFORMATION SITE ADDRESS: 2916 S AVALON RD SPOKANE WA 99206 PARCEL NUMBER: 45274.0704 SUBDIVISION: MOUNTAIN VIEW 4TH ADD LOT: 5 BLOCK: 7 ZONE: UR -3.5 INSPECTOR: FRANK PALADICHUI( WATER DIST: OWNER: ANDERSON, GAYLE PHONE: 509 927 0506 ADDRESS: 2916 S AVALON RD SPOKANE WA 99206 SEWER PERMIT CONTRACTOR H & 5 CONSTRUCTION LICENSE 0: HSCON * *123KF SEWER CONNECTION PROCESSING FEE TOTAL PERMIT FEE 1 10.00 S50.00 P02 S J PROJECT INFORMATION PROJECT NUMBER: 95007533 ISSUE DATE\ 09/20/95 -' PERMIT USE: SEWER CONNECTION - MT VIEW (95S- APPLICANT: N i S CONSTRUCTION PHONE: 509 926 8964 ADDRESS: 11817 E VALLEYWAY AVE SPOKANE WA 99206 CONTACT: N & S CONSTRUCTION PHONE: 509 926 8964 SETBACKS •> FRONT: N/A LEFT: N/A RIGHT: N/A REAR: N/A LENDER NAME: PHONE: ADDRESS: PERMrr(S) PAYMENT SUMMARY PAYMENT DATE RECEIPTS/ PAYMENT AMOUNT 09/20/95 00008867 S50.00 TOTAL FEES AMOUNT PAID AMOUNT OWING 550.00 $50.00 $.00 ISSUED PERMIT BY: BURRIS, ROBIN NOTES ** *FOR SEWER STUB AS-BUILT INFORMATION AND INSPECTIONS, CALL THE COUNTY UTILITIES DEPARTMENT AT 456- 3604 *** CONTRACTOR OR APPLICANT 1S TO FIELD LOCATE AND CONFIRM THE ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER EXCAVATION TO LOCATE BURIED CABLES, GAS PIPING, WATER LINES, ECT. CALL BEFORE YOU DIG (456 -8000) SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO INSURE THAT THEY ARE CLEAR ARO UNOBSTRUCTED TO THE SEWER MAIN ** **** *** CALL FOR INSPECTION PRIOR TO COVER **** * ***** *""•*•* 24 HOUR NOTICE REQUIRED ** ******** Pv# Dept LGFS PAYMENT DOCUMENT SPOKANE COUNTY AUDITOR VENDOR BED TO: BILL TO: H ,DINSTRUCTION 11817. VALLEYWAY AVE. SPOKANE Vendor Contact/Tel WA 992C6 Confirrnmg Order Change Order # Bid ID Blanket# RC# VI# FOB: ACCTG. PERIOD: COMMENTS• PO DATE: DELIVERY DATE: ENTERED BY- BLDG /ROOM: WAREHOUSE: BUYER PURCHASING DIRECTOR. COMM LN# DESCRIPTION COMMODITY NO REF ACCT LINE QUANTITY 1 UNIT UNIT PRICE TOTAL PRICE ;P95,007533_ 116 s. AVALON RD 100% REFUND—DUPLICATE PERMIT TO 95007565 PAuE TOTAL: DISCOUNT TOTAL: FREIGHT TOTAL: SALES TAX TOTAL: c'URCHASE ORDER VALUE: USE TAX TOTAL: 50.00 0.00 0.00 0.00 50 .o ©. LINE NO. FUND AGCY ORG SB ORG I ACT OBI SB OBJ 1 REV SRC SB REV I RPT CAT BS ACCT JOB NO. I PAY THIS AMOUNT P/F 10.00 RECEIVING CERTIFICATION Materials noted in quantity ✓ have been received in good condition or contracted for. SIGNED ^ r / I TITLE ACC DATE 9/2<. PAYMENT CERTIFICATION I, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim, the materials have been furnished, services rendered or labor performed as described herein or contracted for, that the claim is a just, due and unpaid obligation against Spokane County or fund agency indicated above, that I am authorized to authenticate and certify to said claim. SIGNED TITLE OF ICE,'" I DATE \ ft/ DEPARTMENT 2 TRAVEL CERTIFICATION I hereby certify under penalty of perjury that this is a true and correct claim for necessary expenses incurred by me and that no payment has been received by me on account thereof. SIGNED TITLE DATE PAGE