1992, 09-04 Permit: 92007277 Plumbing ReversalSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this perm it/application, state that the information contained in it and submitted by me or my agent to compile said perm it/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not I understand that the issuance of this permit/application and any subsequent inspection approvals or Ceridicates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of any state or local
laws regulating construction
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT NUMBER= 92007277
ISSUED PERMIT DATE= 09/04/92 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 2621 S HOUK CT
ADDRESS= SPOKANE WA 99216
PERMIT USE= PLUMBING REVERSAL
PARCEL= 45273.2906
PLAT*= 001230 PLAT NAME= HILLCREST ACRES 7TH ADD
BLOCK= 2 LOT= 6 ZONE= SFR DIST*= F
AREA= 00000000 F/A= F WIDTH= DEPTH= R/W=
* OF BLDGS= * DWELLINGS= 1 WATER DIST =
OWNER= TRIMBLE GARTH PHONE= 509 927 0430
STREET= 2621 S HOUK CT
ADDRESS= SPOKANE WA 99216
CONTACT NAME= COURCHAINE EXCAVATION PHONE NUMBER= 509 924 5485
BUILDING SETBACKS: FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
***************************** PLUMBING PERMIT ******************************
CONTRACTOR= COURCHAINE CONSTRUCTION
STREET= 16402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
ITEM DESCRIPTION
PHONE= 509 924 5485
QUANTITY FEE AMOUNT
PROCESSING FEE Y
MISCELLANEOUS
MINIMUM FEE ADJUSTMENT Y
1
25.00
6.00
4.00
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE
09/04/92
TOTAL DUE=
PERMIT TYPE:
RECEIPT* PAYMENT AMOUNT
7389 35.00
.00 TOTAL PAID= 35.00
FEE AMOUNT AMOUNT PAII) AMOUNT OWING
PLUMBING PERMIT 35400
35400
PROCESSED BY: DOMITROVICH, ROBIN
PRINTED BY: DOMITROVICH, ROBIN
35.00 .00
35400 .00
******************************** THANK YOU *********************************
OFFSET
RECEIVABLES
ACCQUNT
•
VENDOR
CODE
COURCHAINE CONSTRUCTION
NAME
REFIITD
SPOKANE COUNTY PAYMENT VOUCHER NUMBER 132011
ADDRESS 16402 EAST VALLEYWAY
SPOKANE, WA 99206
ACCOUNT DISTRIBUTION, ORIGINATING ENTITY (ALL VOUCHER TYPES)
LINE
NO.
VENDOR
INVOICE NUMBER
FUND AGENCY ORGAN-
IZATION
ACT
OBJ
SUB REV SUB
OBJ SOURCE REV
JOB
NUMBER
REPT
CATEG
BS
ACCT
DATE
11/4/92
AGENCY CODE ENFORCEMENT
NAME
AUDITORS STAMP
❑ 1099 REQ'D ID4t
DESCRIPTION
AMOUNT
406
0008
2210
16.00
401
436
0000
4240
54.00
406
03r,
0008
2210
56.00
DETAIL DESCRIPTION
1 & 2 PERMIT 92-008690 FOR 3026 SOUTH RAYMOND CIRCLE AND PERMIT #92-0092-007275
FOR 2621 SOUTH HOUK CT AS FOLLOWS:
$10.00 X 8C% = 8.00 X 2 = $ 16.00
$40.00 X 100% = 32.00 X 2 = 64.00
PERMIT #92-007277 FCR 2621 SOUTH HOUK CT AND #92-008597 FUR 12818 EAST
23RD AVE AS FOLLOWS:
$35.00 X 80% = 28.00 X 2 = $56.00
PER COPIES OF PERMITS AND INTER ATTACHED.
INTRA -GOVERNMENTAL VOUCHER
SELLERS ACCOUNT DISTRIBUTION
FUND IAGENCVI ORGAN- SUB
II IZATION ORG
ACTIVITY REVENUE
SOURCE
SUB
REV
SRC
JOB NUMBER RPT
CATEG
SELLER CERTIFICATION
I, hereby certify that the materials have been furnished, the services
rendered or the labor performed as described herein or contracted
for, 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.
CERTIFICATION
SIGNED
TITICE ADMINISTRATOR
DATE
11/4/92
TOTAL
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
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