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2002, 02-15 Permit: 01007367 Refund Request
02/15/2002 FRI 12:56 FAX 509 893 0006 BELFOR BELFOR Construction Services Telefax TO: Pcl. DATE: Zf/3102- COMPANY: S'Po / FAX NUMBER: 77 7 7a FROM: Gill Pages including cover sheet: 614 r�T 1' % 07S� Ie 42 pet I Cj001/001 CO Cif: c£/11E�/ ,� ?'zc^'e^. d A) Z}0/1)e- 7 }o/ E7 ?►2£ `.4,'s-� L1 1.Q -F- IS E. `tea ►�� Should you have any questions or comments, please feel free to contact me at (509) 893-0001, (509) 979-3588 cell. Thank you, Gill BELFOR CONSTRUCTION SERVICES 10020 East Knox Sake 100, Spokane, WA 99206 609893.0001 800.107.3601 Seattle • Portland • Spokane • Yakkha OR c 183538 • WA BELF0U 990BT Fax: 609.893.0006 Project Receipt Summary Wednesday, February 20, 2002 Pagel of Address 515 S CHRONICLE RD Spokane WA 99212 Owners Name: PURTTEMAN, GARVIN Address: 515 S CHRONICLE RD SPOKANE, WA 99212 Occupant: Phone: Applicant: BELFOR CONSTRUCTION PROJECT#: 01007367 Phone: (509) 533-9053 Phone: (509) 893-0001 Use: FIRE DAMAGE REPAIR TO INTERIOR WALLS OF RESIDENCE" cancelled Application Date: 8/29/2001 Permit Issue Date: 9/4/2001 Receipt Nbr: 6722 Acct Account Description 00150 STATE SURCHARGE P0120 RESIDENTIAL PMTS 00120 RESIDENTIAL PMTS Tender Type MasterCard Transaction Date/Time: 8/29/2001 1:35:32 PM Transaction P P P Amount Paid $172.86 Total Due $4.50 $47.98 $120.38 $172.86 Payer Amount Paid $4.50 $47.98 $120.38 $172.86 Receipt Nbr: 1014 Acct Account Description 00120 RESIDENTIAL PMTS 00150 STATE SURCHARGE P0120 RESIDENTIAL PMTS Tender Type MasterCard Transaction Date/Time: 2/20/2002 4:01:52 PM Transaction Total Due Amount Paid D $0.00 ($96.30) D $0.00 ($4.50) D $0.00 ($38.38) $0.00 ($139.18) Amount Paid Payer ($139.18) Amount credited to account with batch # 00010194; Trans # 018 n Dcl all 4U RESIDENTIAL ADS f12Q31 $124.311 f12A75 N4 SU ;,STATE SUNCHAR6E i 5150 � fi.50 9 5/.59 1504 _. _. y .. __..... BU IIESN1EIiTUI PNTS��-�.H79i %TPA q $094 504 01507367 2,(RESIDENTIAL PATS t IS4i.341 6TOU2367 Tai 2S RESIDENTIAL PITT5 ' 1534341 01 07 _.. . R.... .... L ..._. 01507362 �+ 2�STATESUf1CJTARGE a IN.50T �`rl M35739.141