1997, 10-14 Permit: 97008429 Plumbing Alteration-VoidSPO
COUNTY -DIVISION OF BUILDING AND PLANNING ,
1026 W. BRoADwAy • SpoKANE, WA 99260-0050
(509) 456-3675
Silk. INFORMATION
PROJECT' INFORMATION
SITE ADDRESS: 906 N BOWMAN RD
SPOKANE WA 99212
PARCEL NUMBER: 35131.1154
SUBDIVISION: UNKNOWN
LOT: 21 BLOCK: 4 ZONE: RMH
INSPECTOR: FRANK PALADICHUK
WATER DIST:
OWNER: CRANE, MARGARET
PHONE: 509 926 9969
ADDRESS: 906 N BOWMAN RD
SPOKANE WA 99212
PROJECT NUMBER: 97008429 ISSUE DATE: 10/14/97
PERMIT USE: INTERIOR PLUMBING ALTERATION FOR SEWER HOOK-UP
APPLICANT: H & S CONSTRUCTION
PHONE: 509 926 7101
ADDRESS: PO BOX 7272
SPOKANE WA 99207
CONTACT: RANDY JACKSON PHONE: 509 926 7101
SETBACKS -> FRONT: NA LEFT: NA RIGHT: NA REAR: NA
_ENDER NAME:
PHONE:
ADDRESS:
PERMIT(S)
PLUMBING PERMIT
CONTRACTOR
JACKSON PLUMBING
LICENSE #: JACKSP*055NS
WATER PIPING - DWV
1
PROCESSING FEE 25.00
MINIMUM FEE ADJUST ENT 4.00
TOTAL PERMIT FEE $35.00
,k\c1 6.Alckac 10eLI_
e
,
PAYMENT SUMMARY
NOTFS
PAYMENT DATE RECEIPT#
10/14/97 00010326
TOTAL FEES AMOUNT PAID
$35.00 $35.00
PAYMENT AMOUNT
$35.00
AMOUNT OWING
ISSUED PERMIT BY: JULIE SHATTO
$.00
Pv#
Dept
VENDOR:
H S CONSTRUCTION
PO BOX 7 272
SPOKANE
Vendor Contact/Tel
LGFS PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
PLAN
SHIP TO:
WA 99207
BILL TO:
PV MV1125700C
Change Order #
Bid ID _
Blanket#
RC#
PO DATE:
DELIVERY DATE:
ENTERED BY:
1000
ENTEREC IN ERROR PRJ:: 97-8429
SITE: 9SSPOKANE N. BOWMAN
99212
DIST: "F"
40 030 00O
tECEIVING RTIFICATION
laterials dot
IGN
ITLE
,ATE
2420
230 ')3
PAYMENT CERTIFICATION that sufficient funds have been budgeted for this claim, the
4 the materials base
sieved n furnished,
, ser ices under penalty o lfabor
perjury
e claim is
a jst, due and unpaid Obligati qn against Spokane County por�fund eag nye indicated above, that rein or tI am aracted s horiiedt tto authenticate
? and certify to said claim.-. ''Sf'
TITLE OFFICE ADMINISTRATOR
SIGNED
DATE 12/01/97
PAGE TOTAL:
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
PURCHASE ORDER VALUE:
USE TAX TOTAL:
RAND TOTAL:
:A9LE
33.00
0.00
0.00
0.00
35.00
0.00
3,.00
.00
TOTAL TO VINO R:
TRAVEL CERTIFICATION u that this
1 hereby certify under penalty of perjury
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
DATE
TITLE
. 00
PAGE _—--___