1991, 05-09 Permit: 91002463 Furnace, Piping Refund--PROJECT NUMBER= 91002463
I%%UED PERMIT DATE= 05/09/9i PAGE= 04
**************************** PERMIT INFORMATION ***************************
SITE STREET= 3328 % GLENN RD PARCEL4= 33542-1403
ADDRESS= SPOKANE WA 99206
PERMIT USE= GAS FURNACE & PIPING
PLATO= 000333 PLAT NAME= CASTLE D.
BLOCK= 5 LOT= 3 ZONE= UR -3,5 DI%T4= F
AREA= F/A= F WIDTH= 80 DEPTH= 430 R/W=
4 OF BLDG%= 4 DWELLING%= i WATER DIST =
OWNER= CAMPBELL, RAEANN PHONE= 509 926 7286
STREET= 3328 % GLENN RD
ADDRESS= SPOKANE WA 99206
CONTACT NAME= ELLEN HOLT PHONE NUMBER= 509 534 4975
BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA
******************************* MECHANICAL PERMIT **************************
CONTRACTOR= NORCO HEATING & AIR COND INC PHONE= 509 534 4975
STREET= 5iO3 E TRENT AVE
ADDRESS= SPOKANE WA 99212
ITEM DE%CRIPTION QUANTITY FEE AMOUNT
-------- -------- ----------
PROCESSING FEE Y 25,00
GAS HTG EQUIP<iOO/OOO>BTU i 12.00
GAS PIPING 1 1,00
****************************** PAYMENT sUMMARY ****************************
PAYMENT DATE RECEIPTO PAYMENT AMOUNT
05/09/94 2744 38.00
TOTAL DUE= DUE= .00 TOTAL PAID= 38.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
MECHANICAL PRMT PRMT ' 38.00 38.00 .8O
------------- ------------ -------------
38.00 38.00 .O0
PROCESSED BY: WENDEL^ GLORIA
PRINTED BY: WENDEL, GLORIA
******************************** THANK YOU ************************«*******
�NDOR MSC
DE
SPOKANE COUNTY PAYMENT VOUCHER
NAME NORCO HEATING & AIR CONDITIONING, INC.
ADDRESS
5103 EAST TRENT AVENUE
SPOKANE, WA 99212
AUDITORS STAMP
ACCOUNT DISTRIBUTION, ORIGINATING ENTITY (ALL VOUCHER TYPES) ■
1099 REQ'D ID#
LINE
NQ,
VENQCift
INVOICE NUMBER
FUND
AGENCY
ORGAN -
RATION
ACT
OBJf
OBJ
SOURCE
REV
NUMBER
CA i[G
ACCT
SCRIPTION
UN
1
#91-002463
406
030
0008
22210
07
REFUND
$30.40
DETAIL
DESCRIPTION
14 80% REFUND ON PERMIT #91-002463 FOR 3328 SOUTH GLENN ROAD
I, the undersigned do hereby
certify under penalty of perjury
TOTAL
30.40
that funds have been
'PROJECT CANCELED PER COPY OF NOTIFICATION & PERMIT ATTACHED
$38.00 X 80% = $30.40
sufficient
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
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
indicated above, that I am autho-
to
TITLE
INTRA -GOVERNMENTAL VOUCHER
rized authenticate and certify
to said claim.
DATE
F Jf it? -,iR
f 1
IZ nAN
Cis
SELLERS
IYITY
ACCOUNT
DISTRIBUTION
JOB NUM ER
CAS.,
\..
EXAMINED and ALLOWED
19
CER FIQATION
DATE
SIGNED - ,..i.177-----61AIRMAN
SELLER CERTIFICATION
I, h eby certify that the materials have been furnished, the services SIGNED
__
TITLE OFFICE ADMINISTRATOR
MEMBER
reared or the labor performed as described herein or contracted TITLE
is due and unpaid obligation, and that
for, and that the claim a just,
I amd4ithorized to authenticate and certify to said claim. DATE
5/28/91
DATE
MEMBER