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1991, 12-16 Permit: 91007348 RefundVENDOR CODE REFUND SPOKANE COUNTY PAYMENT VOUCHER NAME c7m7s4 HEATING ADDRESS EAST 204 INDIANA AVENUE SPOKANE, WA 99207 LINE NO. VENDOR INVOICE NUMBER ACCOUNT DISTRIBUTION, ORIGINATING ENTITY (ALL VOUCHER TYPES) FUND AGENCY ORGAN- IZATION ACT OBJ SUB REV SUB OBJ SOURCE REV JOB NUMBER REPT CATEG BS ACCT NUMBER DATE 129406 12/16/91 AGENCY ^0' E FH='ORCFMFNT AUDITORS STAMP ❑ 1099 REQ'D ID# DESCRIPTION AMOUNT 91-007348 406 030 0008 2210 07 Orr;'tp\I2 DETAIL DESCRIPTION 80% REFUND ON PERMIT #91-007348 FOR 510 SOUTH CARNAHAN RD PROJECT CANCELED PER COPIES OF LETTER AND PERMIT ATTACHED $38.00 X 80% _ $30.40 INTRA -GOVERNMENTAL VOUCHER SELLERS ACCOUNT DISTRIBUTION ORGAN- SUB REVENUE RSEV FUND AGENCY RATION ORG ACTIVITY SOURCE REV SRC JOB NUMBER RPT. CATEG. OFFSET RECEIVABLES ACCOUNT SELLER CERTIFICATION I, hereby certify that the materials have been furnished, the services rendered or the labor performed as described herein or contracted and that the claim is a just, due and unpaid obligation, and that I am authorized to authenticate and certify to said claim. SIGNED TITLE DATE I, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim, the ma- terials have been furnished, ser- vices rendered or labor performed as described herein or contracted for, that the claim is a just, due and unpaid obligation against Spokane County or fund agency indicated above, that I am autho- rized to authenticate and certify to said claim. SIGNED TITLE DATE / \\ CERTIFJCAt1* N I STRATOR 12/16/91 TOTAL 30.40 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 TITLE DATE EXAMINED and ALLOWED DATE 19 CHAIRMAN MEMBER MEMBER 10-29-91 z 6.479. 04* *38,00 *.38.00 *38.006 E *000 813.92 SPOKANE COUNTY DEPARTMENT OF BUILDINGS W.1303 BROADWAY AVENUE SPOKANE, WASHINGTON 99260 (509) 456-3675 this permit/application, state that the information contained In Rand submitted by me or my agent to compile said rmit/apptication is true Spokane County to proceed with processing: In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE and agree to comply with same. AU provisions of laws and ordinances governing this type of work will be complied with whether specified hat the issuance of this permit/application and any subsequent Inspection approvals or Certificates of Occupancy shall not be construed to ncel the provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of any state or local 502), 'rt, "APPLICATION .. . BER= 91007348 104 DATE ISSUED PERMIT DATE= 10/29/91 PAGE= 01 *********** •** •**x•**$**-**** PE::RPIIT INFOR?IATION ********•x*•**•***•**** ****•;' *** SITE STREET= 510 S CARNAHAN RD ADDRESS= SPOKANE WA 99212 PERMIT USE HEATING EQUIPMENT AND GAS PIPING PLAT#:= 999999 PLAT NAME= RANGE. BLOCK= LOT:: ZONE= UR 3.5 DIST4= E" AREA= F/A= WIDTH= DEPTH= OF BLDGS 1 w DWELLINGS= WATER DIST = OWNER= SEREI)AY, MIKE PHONE= 509 535 2899 STREET= 510 S iCARNAHAN RI's ADDRESS::: SPOKANE WA 99212 PARCELI= 23532-9026 ./W:: CONTACT NAME: STURM HEATING INC„ PHONE NUMBER== 509 325 4505 BuI:1_DING SETBACKS: FRONT= N/A LEFT= N/A F<IGHT= N/A REAR= N/A r:**-*•**********-***************** MECHANICAL PERMIT *-***•*****d•***•Arri-* ****ii••)i CONTRACTOR= STURM HEATING STREET • 204 E INDIANA AVE_ ADDRESS= SPOKANE WA 99207 PHONE= 509 325 4505 ITEM DESCRIPTION QUANTITY FEE AMOUNT � F'R©C.'ESSINGFE=.f _.�.....�_ ... _.____�, l':,D GAS HTG EQU:fF'C-t00,000>PTIJ 1 12.00 GAS PIF'INC_;. 1 i .00 ****-*****•*****,x*;'e*•**•****•******* PAYMENT SUMMARY ** * *** ********;....*******Y.-** PAYMENT DATE RECEIPT- PAYMENT AMOU1NT- 10/29/91 0139 38.00 TOTAL. DUE= .00 TOTAL.. I'AI:D=38.00 PERMIT TYPE FEE AMOUNT AMOUNT F'AI:D AMOUNT OWING ------------- MECHANICAL. PRMT 30,00 3E1.00 .00 38.00 38.00 .00 PROCESSED BY: i}0MT-f F 0VTr:II, ROBIN PRINTED BY: DOMITROVICH, ROBIN *•; *****************f+:**•********** THANK YOU *********+c•********* -******••x <****** /2 //2/q/ Ta i,ditto ccencnmL)- ' cu -,E) rcic'-a- Y-14,0 116eq. rqucKi_oc cticA Offockcou