1997, 11-18 Permit: 97009699 RefundPv#
Dept P LAN
REFUND
MV11 771 0013
VENDOR:
K T U OF SPOKANE
PO B OXE28899
PVendor Contact/hi
SHIP TO:
WA 99228
LGFS PAYN TAT DOCUMENT
SPOKANE CCS) UNTY AUDITOR
--11O 1
1� h
Confirming O or \ \ V
BILL TO:
BLDGIROOM:
WAREHOUSE:
PATRICIA LICKSTADT
8011 CANCELLED, PRJ 97-9699
SITE: 1116 S. BOWDISH RD.
SPOKANE WA 99206
DIST: "F"
PV MV111770013
Change Order #
Bid ID —
Blanket#
RC#
VI#
BUYER
r
P RCHASING DIRECTOR: D C N A c - CCU
.: L. LAbRECQU
PAGE TOTAL:
DFREIGH1 TOTAL:
SALES TAX TOTAL:
PURCHASE ORDER VALUE:
USE GRAND TOTAL:
37.60
37.60
0.00
0.00
0.00
37.60
0.00
37.60
' ECEIVIN RTIFICATION
t•tennis not j quant y J have been
rec 'vcd onditl .n or contract •j o
qrsCT CH 3
SIGNE
.I�
TITLE
DATE -1_1. L.1.131.91
ON
PAYMENT CERTIFIC 1
1, the undersl_ .,• reby`v
materials have • yyy�l���r•1
andc ww
us
SIGNED
a r
DATE 1 /
114/07 J
natty of perjury that suRident funds have been budgeted for this claim, the
dered or labor performed to described herein or contracted for. that the claim isSpokane County or fund agency indicated above, that 1 am authorized to authenticate
under
rdyn
TITLE
:lu I 1
TOTAL TO VENDOR:
TRAVEL CERTIFICATION
1 hereby certify under penalty of perjury that this
b e true and correct claim for necessary expenses s been received
Incurred by me and that no payment
by me on account thereof.
SIGNED
DATE
TITLE
37.60
PAGE
1
l
COUNTY_ DWISIQN, OFA BUILDING AND PLANNING;
1026 W BROADWAY ;• SPOKANE; WA 99260-0650,-
•
(509) 4563675
SITE INFORMATION PROJECT INFORMATION
SITE ADDRESS: 1116 5 BOWDISH RD
SPOKANE WA 99206
PARCEL NUMBER: 45213.1112
SUBDIVISION: SOUTH POINT VIEW HOMES SUB
LOT: 6 BLOCK: 2 ZONE: UR -3.5
INSPECTOR: FRANK PALADICHUK
WATER DIST:
OWNER: SAVAGE, MIKE
PHONE:
ADDRESS: 1116 5 BOWDISH RD
SPOKANE WA 99206
PROJECT NUMBER: 97009699 ISSUE DATE: 11/13/97
PERMIT USE: GAS RANGE, DRYER, 8 PIPING (2)
APPLICANT: K T U OF SPOKANE
PHONE: 509 467 4000
ADDRESS: PO BOX 28899
SPOKANE WA 99228
CONTACT: K T U OF SPOKANE PHONE: 509 467 4000
SETBACKS -> FRONT: NA LEFT: NA RIGHT: NA REAR: NA
ENDER NAME:
PHONE:
ADDRESS:
l
PERMIT(S)
)
MECHANICAL PERMIT
CONTRACTOR
K T U OF SPOKANE
LICENSE #: KTUSPI.153MA
RANGE
CLOTHES DRYER
GAS PIPING 2
PROCESSING FEE 25.00
$47.00
TOTAL PERMIT FEE
C
PAYMENT SUMMARY
NOTES
PAYMENT DATE RECEIPT#
11/13/97 00011770
TOTAL FEES AMOUNT PAID
$47.00
$47.00
PAYMENT AMOUNT
S47.00
AMOUNT OWING
ISSUED PERMIT BY: CAROL FRAZIER
Q 1 i pvl-- c le
5.00