2001, 07-19 Permit: 01004393 RefundV
Vendor ID DICKAWSE
Voucher ID 00096796
Rel Vchr ID
Dept ID
VENDOR:
Dick's Awning Services
7809 N Market St
Spokane WA 99217
Vendor Contact/Tel
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
BILL TO:
PAGE 2 OF 2
RC#
INV# 01-4393
ENTERED DATE: 07/19/2001 PO DATE: BUYER:
ENTERED BY: Patty Eickstadt PURCHASING DIRECTOR: BELA G. KOVACS
LINE NO.. DISTRIB LINE. ACCOUNT ` FUND : DEPTID PROGRAM CLASS RPT CAT BDPER ' PC UNIT;. . PAY :THIS.:AIMOUNI
PROJECT ACTIVITY RES. TYPE CATEGORY SUB CAT AWUNIT PROFILE'< ASSET! FLG . ASSET .ID
Comments: 80% = REFUNED PER APPLICANT'S REQUEST TO CANCELL. PRJ # 01-4393
SITE LOCATION: 18417 E. DALTON AVE.; SPOKANE WA 99216
RECEIVING CERTIFICATION
Materials noted in quantity , have been received in goal condition or
contracted for.
SIGNED P��
DATE 7/19/01 TITLLACCT TECH 4
PAYMENT CERTIFICATION
1, the undersigned do hereby certify under penaltyiof perjury that sufficient funds have been budgeted
for this claim, the materials have been furnished, services rendered or labor performed as described
herein or contracted for, that the claim is a just, due and unpaid obligation against Spokane County
or fundagency ' tc ed above, that 1 am authorized to authenticate and certify to said claim.
SIGNED ^t��
DATE 7/19/01 TITLE DIV OF BLDG & CODE
EN CEMENT DIRECTOR
Aa
SIGNE>�./.�/r/� /.. / ) __.
DISCOUNT TOTAL:
0.00
FREIGHT TOTAL:
0.00
SALES TAX TOTAL:
0.00
SUBTOTAL:
261.19
USE TAX TOTAL:
0.00
GRAND TOTAL:
261,19
TOTAL TO VENDOR: 261.19
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
Vendor ID DICKAWSE
Voucher ID 00096796
Rel Vchr ID
Dept ID
VENDOR:
Dick's Awning Services
7809 N Market St
Spokane WA 99217
Vendor Contact/Tel
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO: BILL TO:
PAGE 1 OF 2
RC#
INV# 01-4393
ENTERED DATE: 07/19/2001 PO DATE: BUYER:
ENTERED BY: Patty Eickstadt PURCHASING DIRECTOR: BELA G. KOVACS
LINE N0. DESCRIPTION ITEM ID UANTITY UNIT UNIT PRICE� EXTENDED AMOUNT
PO# CHG ORD#. PO LINE# "PO SCHED# CONTRACT#'
1 BACE'S PORTION OF PRJ# 01-4393 1.0000 LOT 0.00 183.53
0 0 0
2 CRRNT PLNG'S PORTION 1.0000 LOT 0.00 73.16
0 0 0
3 STATE SURCHARGE 1.0000 LOT 0.00 4.50
0 0 0
LINE NO. I DISTRIB LINE T ACCOUNT I FUND I DEPTID I PROGRAM CLASS:RPT CAT BDPER . PC UNIT PAY THIS AMOUNT
PROJECT ACTIVITY RES. TYPB CATEGORY SUB CAT AM UNIT.. PROFILE. ASSET FLG I ASSET ID
1
1 221002 406 0300008
BACE
240 REFND
2
1 221002 406 0300008
BACE
240 REFND
3
1 23700 N20
2001 PROJA 183.53
N
2001 PROJA 73.16
N
4.50
N
'S���o M�►���E 10 bey ►'1` 'NOC P - SUMMARY : Page 1. NOTES
COPY Processed By SHATTO, JULIE.,
Printed.By:..ScBNEEDEP, PENNY
Tran Date -Receipt # Payment Amf'
6/72061 4108 $386;36
Total Fees AmountPaid. Amount"g
$386.36 $38636 $0;00
Project Receipt Summary Thursday, July l9, 2ool Page l of l
Address 18417 E DALTON AVE PROJECT#: 01004393
SPOKNAE WA 99216
Owners Name: REICHERT ETAL, S Phone: (509) 928-6528
Address: 18417 E DALTON AVE
SPOKANE, WA 99216-1752
Occupant. Phone:
Applicant: DICKS AWNING SERVICE Phone: (509) 467-8421
Use: EXISTING DOUBLE WIDE MANUFACTURED HOME (SINCE 1979) & DEN
Application Date: 6f7/2001
Permit Issue Date: 6/7/2001
Receipt Nbr. 4108
Transaction Date/Time:
6!7/2001 11:31:23 AM
Acct.
Account
Transaction
Description
Total Due
Amount Paid
P0120
RESIDENTIAL PMTS
P
$91.45
$91.45
00120
RESIDENTIAL PMTS
P
$229.41
$229.41
00510
RESIDENTIAL PMTS
P
.$61.00
$61.00
00150
STATE SURCHARGE
P
$4.50
$4.50
$386.36
$386.36
Receipt Nbr: 5260
Transaction Date/Time:
7/16/2001 11:22:58 AM
Acct
Account
Transaction
80% REFUNDED
Description
Total Due
Amount Paid
00120
RESIDENTIAL PMTS
R
$0.00
($183.53)
P0120
RESIDENTIAL PMTS
R
$0.00
($73.16)
00510
RESIDENTIAL PMTS
R
$61.00
$0.000
00150
STATE SURCHARGE
R
$0.00
($4.50)