2000, 09-22 Permit: 00008446 RefundVendor ID NORTHEAI
'- Voucher ID 00056986
Rel Vchr ID
Dept ID
VENDOR:
Northland Heating & Air
PO Box 1420
Mead
Building and Code Enforcement
Vendor Contact/Tel
WA 99021
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
BILL TO:
PAGE 2 OF 2
RC#
INV# 00-3803&8446
ENTERED DATE : 09/22/2000 PO DATE:
BUYER:
ENTERED BY: Patty Eickstadt PURCHASING DIRECTOR: BELA G. KOVACS
LINE NO.
DISTRIB LINE
ACCOUNT
FUND
ORG '>
PROGRAM
SUB -CLS
RPT CAT
B. YR II! PC UNIT
PAY THIS AMOUNT'
PROJECT
ACTIVITY
RES. TYPE
CATEGORY
SUB CAT
AM UNIT
PROFILE ! ASSET FLG
ASSET ID
Comments:
100% REFND'D ON PRJ# 00-8847; SITE LOCATION = 1308 S. GROVE ST.,
SPOKANE WA 99204 80% REFND'D ON PRJ # 00-8446; SITE LOCATION =
19016 E. MONTGOMERY, OTIS ORCHARDS WA 99027
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
SUBTOTAL:
USE TAX TOTAL:
GRAND TOTAL:
TOTAL TO VENDOR:
.00
.00
.00
64.80
.00
64.80
64.80
RECEIVING CERTIFICATION
Materials noted in quantity * have been received in good condition or
contracted for.
PAYMENT CERTIFICATION
1, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted
for this c aterials have been furnished, services rendered or labor performed as described
herein o contracted for, tha e claim is a just, due and unpaid obligation against Spokane County
or fund age cy indica bove, th I am authorized to authenticate and certify to said claim.
SIGNED
DATE9/22/00
TITLE ACCT TECH 3
DATE 9/22/00 TITLE OFFICE ADMINISTRATOR
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
DATE TITLE
Vendor ID NORTHEAI
Voucher ID 00056986
Rel Vchr ID
Dept ID Building and Code Enforcement
VENDOR:
Northland Heating & Air
PO Box 1420
Mead
Vendor Contact/Tel
WA 99021
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
BILL TO:
PAGE 1 OF 2
RC#
INV# 00-3803&8446
ENTERED DATE : 09/22/2000 PO DATE:
ENTERED BY: Patty Eickstadt
BUYER:
PURCHASING DIRECTOR: BELA G. KOVACS
LINE NO.
DESCRIPTION
PO#
CHG ORD#
INV ITEM ID
PO LINE#
QUANTITY
UNIT
PO SCHED#
UNIT PRICE
EXTENDED AMOUNT
CONTRACT#
1
2
100 % - PRJ# 00-8447
80 % - PRJ# 00-8446
0
0
1.0000
1.0000
EA
0
EA
0
36.00
28.80
36.00
28.80
LINE NO.
DISTRIBLINE
ACCOUNT
FUND
ORG
PROGRAM
SUB -CLS
RPT CAT
B. YR 'I PC UNITI
PAY THIS AMOUNT
PROJECT
ACTIVITY
RES:' TYPE
CATEGORY
SUB CAT
AM UNIT>
PROFILE
ASSET FLG
ASSET ID
1
BACE
2
BACE
1
1
221007 406
240 REFND
221007 406 0300008
240 REFND
0300008
2000
2000
PROJA
PROJA
N
N
36.00
28.80
SPOKANE COUNTY DIVISION OF BUILDING AND CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
(509) 477-3675
SITE INFORMATION
PRO CT INFORMATION
Site Address: 19016 E MONTGOMERY DR
Project Number: 00008446 Inv: 1 Issue Date: 9/20/00
OTIS ORCHARDS, WA 99027
Permit Use: GAS LOG, PIPING
Parcel Number: 55082.1020
Subdivision: UNKNOWN
Applicant: NORTHLAND HEATING & AIR
Block: Lot:
PO BOX 1420
MEAD WA 99021 Phone: (509) 456-7478
Zoning: UR -7 Urban Residential -7
Contact: NORTHLAND HEATING & AIR
Owner: HARFORD, DELWIN D & HELEN F
PO BOX 1420
Address: 19016 E MONTGOMERY DR
MEAD WA 99021 Phone: (509) 456-7478
OTIS ORCHARDS, WA 99027
Setbacks -Front: Left: Right: Rear:
Inspector: LEONARD FLUNO
Water Dist:
Group Name:
Project Name:
PERMIT(S)
Mechanical Permit Contractor: NORTHLAND HEATING & AIR License #: NORTHHAO24QQ
PROCESSING FEE
$25.00 GAS PIPING 1 $1.00
GAS LOG OR GAS INSERT 1 $10.00
Total Permit Fee: $36.00
J -P 0 1 7� 6
owl/��d
41,2� x1" 6ace '-6 /W&,L&--uo(
PAYMENT SUMMARY Page 1 of 1 NOTES
PERMIT Processed By: DAWN DOMPIER
Printed By: CUM IINGS, KATHY
Tran Date Receipt # Payment Amt
9/20/00 7915 $36.00
Total Fees AmountPaid AmountOwing U
$36.00 $36.00 $0.00 �\
Project Receipt Summary Monday, September 25, 2000 Page 1 of l
Address 19016 E MONTGOMERY DR PROJECT#: 00008446
OTIS ORCHARDS, WA 99027
Owners Name: HARFORD, DELWIN D & HELEN F Phone: (509) 922-8832
Address: 19016 E MONTGOMERY DR
OTIS ORCHARDS, WA 99027
Occupant:
Applicant: NORTHLAND HEATING & AIR
Phone:
Phone: (509) 456-7478
Use: GAS LOG, PIPING "' CANCELLED 9/25/00 PAP"'
Application Date: 9/20/00 Permit Issue Date: 9/20/00
Receipt Nbr: 7915 Transaction Date/Time: 9/20/00 11:32:30 AM
Acct Account
Description
00410 MECHANICAL PMTS
Receipt Nbr: 8082
Acct
00410
Account
Description
MECHANICAL PMTS
Transaction
P
Transaction Date/Time:
Transaction
R
Total Due Amount Paid
$36.00 $36.00
$36.00 $36.00
9/25/00 11:04:00 AM
Total Due Amount Paid
Dv ID: PPS a 56986 E.Fm ■w Date.
fl.— APPEIEANI CANCEEIED. PAPI