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1997, 12-16 Permit: 97004787 RefundVENDOR: INLAND TRADING 1727 W PINTO AVE SPOKANE Vendor Contactlrel WA 99207 SHIP TO: LGFS PAYMENT DOCUMENT SPOKANE COUITTY AUDITOR Confirming Order BILL TO: PV MV121570004 Change Order # Bid ID Blanket# RC# VI# FOB: ACCTG. PERIOD: 1 2/ 97 COMMENTS: COMM LN# DESCRIPTION PO DATE: DELIVERY DATE: ENTERED BY: BLDG/ROOM: WAREHOUSE: PATRICIA EICKSTADT BUYER PURCHASING DIRECTOR: _DEIN fl 1 t A R R F C Q U F COMMODITY NO REF ACCT LINE 80%1 CANCELLED, PRJ :97-4787 SITE: DIST: "H" 2604 N ELLA RD SPOKANE WA 99206 QUANTITY UNIT UNIT PRICE TOTAL PRICE PAGE TOTAL: DISCOUNT TOTAL: FREIGHT TOTAL: SALES TAX TOTAL: PURCHASE ORDER VALUE: USE TAX TOTAL: GRAND TOTAL: 4.50 110.29 114.79 0.00 0.00 0.00 114.79 0.00 114.79 LINE NO. 01 N20 0? 406 AGCY ORG 675 030 0008 SB ORG ACT 2'420 OBJ SB OBI REV SRC SB REV RPT CAT BS ACCT JOB NO, PAY THIS AMOUNT P/F 2210 07 3700 TOTAL TO VENDOR: 4.50 110.29 114.79 RECEIVING CERTIFICATION Ma erials not, . quanti ✓ have been rec=t ed in :•• ernditir or cgntrracted f../ SIGNElarflert ‘72 TITLE DATE ACCT TECH 3 12/16/97 PAYMENT CERTIFICATION 1, the LWensign• • ereby certify under penalty of perjury that sufficient funds have been budgeted for this claim. the _ materijiiss have been fu ed, ser 'ces rendered or labor performed as described herein or contracted for, that the claim is a just. dtie and unpaid ob=: tip against Spokane County or fund agency Indicated above, that 1 am authorized to authenticate and certifyo said cls DATE 12/16/97 TITLE OFFICE ADMINISTRATOR ACCOUNTS PAYABLE 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 I I'ILE DATE PAGE SPOKANE COUNTY DIVISION OF BUILDING AND PLANNING 1026 W. BROADWAY • SPOKANE, WA 99260-0050 (509) 456-3675 J SITE INFORMATION PROJECT INFORMATION SITE ADDRESS: 2604 N ELLA RD SPOKANE WA 99206 PARCEL NUMBER: 45072.6003 SUBDIVISION: ORCHARD AVENUE ADD (TR.1-228) LOT: BLOCK: 194 ZONE: UR 7 INSPECTOR: GEORGE KRIENKE WATER DIST: OWNER: HITCHCOCK, DEAN PHONE: 509 926 3031 ADDRESS: 2604 N ELLA RD SPOKANE WA 99206 PROJECT NUMBER: 97004787 ISSUE DATE: 07/03/97 PERMIT USE: STORAGE SHED APPLICANT: INLAND TRADING PHONE: 509 459 3420 ADDRESS: 1727 W SINTO AVE SPOKANE WA 99207 CONTACT: INLAND TRADING PHONE: 509 459 3420 SETBACKS -> FRONT: NA LEFT: 50 RIGHT: 30 REAR: 13 LENDER NAME: PHONE: ADDRESS: PERMIT(S) BUILDING PERMIT CONTRACTOR INLAND TRADING CO. INC. LICENSE #: INLANTC066NK NEW BUILDING DIM.= 20 X 24 1 STORIES SO FT = 470 STORAGE U-1 VN 480 TOTAL VALUE: 35,760.00 RESIDENTIAL VALUATION 113.00 RESIDENTIAL SURCHARGE 24.86 STATE SURCHARGE 4.50 TOTAL PERMIT FEE 3142.36 i} (V%C !CCCk )-\Q+ rAcleci I, .1. '_C cue ( -V)7 PAYMENT SUMMARY NOTES PAYMENT DATE RECEIPT# PAYMENT AMOUNT 07/03/97 00005990 3142.36 TOTAL FEES AMOUNT PAID AMOUNT OWING 3142.36 3142.36 3.00