1991, 06-03 Permit: 91003030 Furnace, PipingSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 13Q3 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/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 Certificatesof Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PPOjECT NUMBER- 91003070
ISSUED PERMIT 014/07/Ti
ii ti' _: s =='i ii :, }: ii n: } • •},:.i'a ik F=: yi �L :r ii iE iE 7E ii �, y, F' f:_ I't P"t.l, t .i. N ;- oR I 1 f i 1 .I. t i ; k• •}i ii )E j .}4 r }i )('Ji' li' 'Ji �,, .},.: _: •i• ,, .},; .,,..JR . , a ..} �i .. �,.
_...: T• F:: > " : : ;' :_. i `. A i H A LN
P;'.
WA
99216 92
" t.::R":r USE= INSTALL c?rt1GASPTPING
PLAT42. 001436 ?••.... . NAME= l.. -, f•' I A LANE ..i ' 1/
IT— :? ZONE= AGEUB
BLOCK= r.''A WIDTH-
OE
:i 1Tf :.+ii BLDG,..:_. 4 DWELLINGS= , WATER
DTST
MASON, RICHARD
319 LFATHA LN
•F' l:ArgE, WA `.rN:.i...
::4 i (:ii, i NAME= SEARS
...x ... ... ..... TBAt. —. FRONT— NA
PHONE—PHONE
PHONE NUMBER= 309 '3,9 11'70
T Gi•- -- NA i;:EAi:.. NA
;t..}�..t t :::.:a :a.: t a=::.+:: •.::::: i.:::,i.:: •.: ,:: i : '. '.i.:: , :: �:: i • : P },. '}4 1, i `I F. : �7 P -J ,• ' A 0.. i •: ''}i •A i=: : '}=i 'li• '}i• :d' {+i• i'+::_: i'k 'P: '}=r 'Y. !......-..-.:=4 h..=r -N:.+k i .
., .t .1 ...l .. )4 .... H JS tt 1. A .. ,k 1. 1. N. ,... ,4 1 1 �' .... "� i,..._. f'L... k�.l. (
CONTRACTOR= SEAH:.E
STREET= P 0 BOX 7707
ADDRESS- ,?}i OiiA1tiE: WA 99220
PHONE
ITEM DESCRIPTION QUANTITY is.T.E AM;..I;::I_
PROCESSING FEE Y 00
C1A HTCr ET1 1..' t.1 -'t •i i;}ij , 000 j sF i U i t O,:;
GAS PIPING ,:i0
;+i ')i )c i=: }()_: ai :, :k i!• 3F :i :Ji.:ti• •ii.... i=: iy: }i' }i• ),: ii' ' .) i ` A y M E N •t •i i. i ii M t^t R y r: X. }i... yi- •}i• ii ii iE i; a; ;Ir .i;..i;• .ii• :.. •.. •ii' } :
PAYMEN1 DATE
06/03/91
'TOTAL DUE -
PERMIT TYPE
RECEIPT4 PAYMENT AMOUNT
7.389
.00 TOTAL "#'-i T!::.. 38,00
AMOUNT iN'i F A:T} t:•tMfiiiN T OWTNG
FEF AMOUNT
..........................................
38.014
33.00
38.00 .00
JOHN i..r1Ft:: CiN
is 'i`:'i.: Ai ;''r` • JOHN i...AR... :ii`,i
.,: :.;. .. �.:::: •.:,r.: r. .e:. '.a::ri di !i- ai '_ :�_ : i 'e:: i.:=t.: i. • t.: i:: (..�; i:. t dlr •}i' =r .' •1=r =ii P: 'Pi =i i',i _.' •Ji• •ii•'Pi N'Pi it -'!=i i==i iii iii'{ur': :=r 9=i •}i '}i•
...::.:_.Jt:.J...............J... J. J. .. ,. .. 1. 1. 1. 1. .. }. k;i ii ii ie ,,•1.,;�•, :. fou .1 N
IN/O/.ICC RECAP AND DISBURSEMENT VOUCHER
PAY TO .;-I 11{ f.' ' ( (lI` U' / ! �� •
`;( (�(� `� ✓.fel {
t
)J ((' f (.i �7 ! P f C C' , STORE NO.
CUSTOMER'S NAME
SALESCHECK
NUMBER
STORE J
JOB I.D. NO. OR
WORK ORDER NO.
As-,/() _/(
AMOUNT
DUE
CONTRACTOR
No. 378172
DATE i •'[� l�
ALLOCATION OF EXPENSE — FOR INSTALLATION OFFICE USE
CONTRACTOR MEMO
ACCT. EXPENSE SELLING
ACCOUNT DIV.
NUMBER NO. ADJUSTMENT ACCT
1-idf ((r.
Joe-) - 7( /9
P'v
r
Jay 4 .4110.4
i1llf T �
l
I certify that the installations listed above have all been
completed satisfactorily in accordance with the speci
fications furnished me.
TOTAL
AMOUNT
0
LS
(CONTRACTOR'S SIGNATURE)
OK TO PAY r #�--�
ORIZED-SIGNATURE)
CHECK NO.
14489 (See Bul. 0-187 Part II Supp. 8) REV. 3/91 SEARS FORMS MANAGEMENT
(DATE)
PAYING UNIT NO �� ) l
PAYING
UNIT NAME
(If Different)
CONTRACTOR'S FILE COPY