HomeMy WebLinkAbout2002, 05-02 Permit: 02003155 RefundProject Receipt Summary Thursday, May 02, 2002
00120 RESIDENTIAL PMTS
00150 STATE SURCHARGE
Tender Type
Checkl
Page 2of2
P $65.86 $65.86
P $4.50 $4.50
$172.11 $172.11
Amount Paid Payer
$193.22 HENDERSON ROOFING INC
$21.11 is being refunded with PPS voucher # 00136217
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Spokane County
Public Works Department
Division of Building & Code Enforcement
Receipt
Receipt Nirriber: 2944 Customer Number
Projects
Miscellaneous Items
Full
Project Nbr Inv Nbr Fee Amt Inv Amt Owing PAID Pmt
02003155 1 $172.11 $172.11 $172.11 $172.11
Total: $172.11 $172.11 $172.11 $172.11
Total PAID: $172.11
Tender
Type Check Acct Balance CC Nbr Exp Date TENDERED
Checkl 2428 193.22
Payer: HENDERSON ROOFING INC
.Votes: inves fee figured wrong 02-3155 refund please
Tran Date/Time: 5/1/2002 3:5737 PM
By: PSchneid
Logon User: PSCHNEID
Station: PSCHNEID
Override By: jforry
Total TENDERED: 193 22
Over / (Short) $21.11
Change 50.00
HENDERSON ROOFING AND CONSTRUCTION INC.
1003 S. PINES
SPOKANE, WA 99206
PH. (509) 928-7254
U.S. BANK
1 800 US BANKS
U.S. BANK OF WASHINGTON
NATIONAL ASSOCIATION
19-10/1250
PAY TO THE Spokane County Building Permits
ORDER OF
2428
4/30/2002
$ **193.22
One Hundred Ninety -Three and 22/100*****************************************************************************
FOR
Spokane County Building Permits
1026 West Broadway
Spokane. WA 99260
if
II '00 24 2811' 1: L 25000 L051: L535908 3 35 LOH'
DOLLARS
w
Voucher ID 00136217
Vendor ID HENDROOF
Invoice # RCPT# 2944
Dept ID
VENDOR:
Henderson Roofing, Inc
1003 S Pines Rd
Spokane
Vendor Contact/Tel
WA 99206
ENTERED DATE : 05/02/2002 PO DATE:
ACCTG. PERIOD 05/2002
LINE NO. I D
1
/S S w4 s/ -r
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
BILL TO:
PAGE 1OF 1
Rel Vchr
RC#
ENTERED BY: Patty Eickstadt
DESCRIPTION
I ITEM ID
PO# I CHG ORD#
OVERPAYMENT FOR PRJ #02-3155
0
BUYER:
PURCHASING DIRECTOR: BELA G. KOVACS
QUANTITY I UNIT I
PO LINE# I PO SCHED#
0
0.0000
0
UNIT PRICE I EXTENDED AMOUNT
CONTRACT#
0.00
21.11
LINE NO. 1 DISTRIB LINE I ACCOUNT 1 FUND I DEPTID 1 PROGRAM 1 CLASS I RPT CAT I BDPER 1 PC UNIT I PAY THIS AMOUNT
1
BACE
Comments:
PROJECT I ACTIVITY
1 36981
240
RES. TYPE I CATEGORY
406 0300008
REFND
1 SUB CAT f AM UNIT I PROFILE I ASSET FLG I ASSET ID
2002 PROJA 21.11
N
100% - REFUNDED THE DIFFERENCE OF A CHECK PAYMENT TO PRJ # 02.3155
SITE LOCATION:3515 S. BOWDISH RD.; SPOKANE WA 99206
RECEIVING CERTIFICATION
Materials noted in quantity * haw been received in good condition or
contracted for.
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
SUBTOTAL:
USE TAX TOTAL:
GRAND TOTAL:
TOTAL TO VENDOR:
0.00
0.00
0.00
21.11
0.00
21.11
21.11
SIGNED
DATE 52/02 — TITLE ACCT TECH 4
PAYMENT CERTIFICATION
1, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted
for this c : ,.ials have been furnished, services rendered or labor performed as described
herein r contracted for,
or fund gency indicated a'
hP 1 am authorized to authenticate and certify to said claim.
im is a just, due and unpaid obligation against Spokane County
SIGNED
DATE 5/2 •2 TITLE OFFICE ADMINISTRATOR
TRAVEL CERTIFICATION
1 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
DATE
TITLE