1998, 01-02 Permit: 97003992 RefundREFUND
v#.
MV123170001
Dept
030 - BUILD E PLAN
VENDOR:
LACROIX, RONALD
7320 N CARLISLE AVE
SPOKANE WA 99212
SHIP TO:
LGFS PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
PTic le__
Vendor Contact/fel Confirming Order
BILL TO:
PV MV12317001
Change Order #
Bid ID
Blanket#
RC#
vI#
FOB: PO DATE: BLDG/ROOM: BUYER
ACCTG. PERIOD: 12/97 DELIVERY DATE: PATRICIA. EICKSTAAREHOUSE: DONALD Le LA°RECGUE
COMMENTS: ENTERED BY: PURCHASING DIRECTOR: EI
COMM LN#
DESCRIPTION
COMMODITY NO
REF ACCT LINE
QUANTITY
UNIT
UNIT PRICE
TOTAL PRICE
80%, CANCELLED, PRJ::97-3992
SITE:
Dist. Itd1'
49AO fr-ST
7320 E. CARLISLE AVE.
SPOKANE WA 99212
PAGE TOTAL:
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
PURCHASE ORDER VALUE:
USE TAX TOTAL:
GRAND TOTAL:
4.50
232.29
236.79
0.00
0.0G
0.00
236.79
0.00
236.79
t LINE
1
02
FUND
N2
0
406
rAGCY -
ORG''
SB' ORO
ACT
" OBI
SB.OBj
"•REV. SRC'
SB REV'__
RPT CAT
BS ACCT
TOB NO.'.
PAY THIS AMOUNT
P/F
675
030 0008
2420
2210
02
3700-
4 •50
232.29
TOTAL TO VENDOR: ' 236.79
RECEIVING CERTIFICATION
Materials not M. gdantiry / have been
received in y � • conditir o contracted 1.
SIGNE
TITLE
DATE / (//
PAYMENT CERTIFICATION
1,
e undersign y certify
t . .Is have been funs\ nen ices re
-JusI, a and unpaid ohlsl tion agai.
MO
d certif
SIGNED
penalty of perjury that sufficient funds have been budgeted for this claim, [he
dered or labor performed as described herein or contracted for, that the claim is
Spokane County or fund agency indicated above, that 1 am authorized to authenticate
DATE
TITLE
oMice administrator
ACCOUNTS PAYABLE
TRAVEL CERTIFICA'FION
I hereby certify under penalty of perjury that this
b 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
PAGE
1
SPONTE COUNTY DIVISION OF BUILDING AND PLANNING
1026 W. BROADWAY • SPOKANE, WA 99260-0050
(509) 456-3675
SITE INFORMATION
PROJECT INFORMATION
SITE ADDRESS: 7320 E CARLISLE AVE
SPOKANE WA 99212
PARCEL NUMBER: 35121.6248
SUBDIVISION: ROLL ACRES ADD.
LOT: BLOCK: N13 ZONE: UR -3.5
INSPECTOR: MARC STRAUB
WATER DIST:
OWNER:
PHONE:
ADDRESS:
LACROIX, RONALD
509 927 7085
7320 E CARLISLE AVE
SPOKANE WA 99212
PROJECT NUMBER: 97003992• ISSUE DATE: 06/19/97
PERMIT USE: DETACHED SHOP (28 X 46
APPLICANT: LACROIX, RONALD
PHONE: 509 927 7085
ADDRESS: 7320 E CARLISLE AVE
SPOKANE WA 99212
CONTACT: RON LACLOIX
SETBACKS -> FRONT: EXIS LEFT: 67
LENDER NAME:
PHONE:
ADDRESS:
FROM PACIFIC CONTRACTORS)
PHONE: 509 927 7085
RIGHT: 32 REAR: 6
BUILDING PERMIT
CONTRACTOR
OWNER
LICENSE #:
NEW BUILDING
DIM.= 28 X 46 1 STORIES
SO FT = 1288
GARAGE U-1 VN 1288
TOTAL VALUE: $15,456.00
RESIDENTIAL VALUATION
RESIDENTIAL SURCHARGE
STATE SURCHARGE
TOTAL PERMIT FEE
238.00
52.36
4.50
5294.86
CID
10 %SP
- 5a. i
PERMIT(s)
PAYMENT DATE RECEIPT# PAYMENT AMOUNT
06/19/97 00005468
TOTAL FEES AMOUNT PAID AMOUNT OWING
$294.86
$294.86 $294.86
ISSUED PERMIT BY: CHRISTY HARGRAVE
Cfp1d- Ile
$.00
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