1994, 12-15 Permit: 94004790 RefundVendor Contact/Tel
LGFS PAYMENT DOCUNMNT
SPOKANE COUNTY AUDITOR
SHP M. BML TO:
Cordhnft Order
Change Order #.
Bid ID
Blanket#
RC#
VI#
FOB: PO DATE: BLDG/ROOM: BUYER _
ACCTG. PERIOD: DELIVERY DATE: WAREHOUSE:
COMM LN# DESCRIPTION
COMMODITY NO REF ACCT LINE QUANTITY UNIT UNIT PRICE TOTAL PRICE
'194005047 _ 22 N. Mc CABE RD - DUPLICATE PMIT TO #9400790 - I fM RFY
UIOA WRSAS
SYSTEM VOID
LINE NO. I FUND 1 AGCY I ORG I SB ORG ACT 0131 SB OBI REV SRC I SB REV I RPT CAT I BS ACCT JOB NO. PAY THIS AMOUNT PIF
RECEIVING CERTIFICATION PAYMENT CERTIFICATION TRAVEL CERTIFICATION
Materials noted in quantity V have been 1, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim, the I hereby certify under penalty of perjury that this
received in good condition or contracted for. materials have been furnished, services rendered or labor performed as described herein or contracted for, that the claim is is a true and correct claim for necessary expenses
a just, due and unpaid obligation against Spokane County or fund agency indicated above, that 1 am authorized to authenticate incurred by me and that no payment has been received
SIGNED and certify to said claim. by me on account thereof.
TITLE SIGNED TITLE SIGNED TITLE
DATE DATE DATE PAGE
DEPARTMENT2
SITE INFORMATION PROJECT INFORMATION
SITE ADDRESS: 22 N MCCABE RD PROJECT NUMBER: 94005047 ISSUE DATE: 06/08/94
SPOKANE WA 99216
PERMIT USE: HEAT PUMP
ARCEL NUMBER: 45154.2513
APPLICANT: NEAT TRANSFER
SUBDIVISION: MCCABE'S HOME TRACTS SUB PHONE: 509 482 2000
LOT: 13 BLOCK: 1 ZONE: AGSUB ADDRESS: 3003 N CRESTLINE
SPOKANE WA 99207
INSPECTOR: REED OCKEY
WATER DIST:
OWNER: CARVETH, DIANA
PHONE: 509 921 1011
ADDRESS: 22 N MCCABE RD
SPOKANE WA 99216
CONTACT: HEAT TRANSFER PHONE: 509 482 2000
SETBACKS -> FRONT: NA LEFT: NA RIGHT: NA REAR: NA
LENDER NAME:
PHONE:
ADDRESS:
ENT DATE
/08/94
TAL FEES
$37.00
RECEIPT$ PAYMENT AMOUNT
------- --------------
00006281 $37.00
AMOUNT PAID AMOUNT OWING
$37.00 S.00
ED PERMIT BY: DAWN DOMPIER
NOTES
I
SITE ADDRESS: 22 N MCCABE RD
SPOKANE WA 99216
PARCEL NUMBER: 45154.2513
SUBDIVISION: MCCABE'S HOME TRACTS SUB
LOT: 13 BLOCK: I ZONE: AGSUS
INSPECTOR: REED OCKEY
WATER DIST:
OWNER: CARVETH, DIANA
PHONE: 509 921 1011
ADDRESS: 22 N NCCABE RD
SPOKANE WA 99216
PROJECT NUMBER: 94004790 ISSUE DATE: 05/26/94
PERMIT USE: AIR CONDITIONER
APPLICANT: HEAT TRANSFER INC
PHONE: 509 482 2000
ADDRESS: 3003 N CRESTLINE
SPOKANE WA 99207
CONTACT: HEAT TRANSFER INC PHONE: 509 482 2000
SETBACKS -> FRONT: NA LEFT: NA RIGHT: NA REAR: NA
LENDER NAME:
PHONE:
ADDRESS:
rAYMEIHT $I.
I OATF be .w -r
------------- FATMENT AMOUNT
--------- --
' 00005781 137.00
FEES AMOUNT PAID
------ AMOUNT OWING
$37.00 ------------
$37.00 -------- $.00
'EMIT BY: CAROL BRADBURN
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