Loading...
1992, 11-30 Permit App: 92010453 Plumbing Fixturesfo PLUMBING PERMIT APPLICATION FORM Information Worksheet ESS: o JOB STREET ADDRESS: CITYISTATEOP:— C,-�iqc Cl 20C, PARCEL NUMBER: OWNER:-- k vy, nnecS r PHONV NUMB MAILING ADDRESS! • (Street) -D- (CItylstate) (23p)�� CONTRACTOR:- C(O LICENSE NUMBFJ:L- yn� P INUMB HON 7> V, MAILING ADDRESS: "F- c- (CitylSt tate) (ZIP) (Street) (cityls 8) PLUMBING WORKSHFF I IFEESCHEDULE NOTE'. MINIMUM PERMIT FEE IS $35-00 SIGNATU cr%Mr-12mes rf%ffnfir n;%f;o;nn of R11HAinne SPOKANE COUNTY DEPARTMENT OF BUILDINGS W. 1303 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; l 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 Certificates of Occupancy shall not be construeb 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 C APPLICATION OWNER OR AGENT,' —r? CG )t. {t, Cf. L (-C—A.Q DATE f: PROJECT NUMBER- 92t7it)453 ISSUED PERMIT DA'T'E"= ii/30/92 PAGE"::: 01 3e. k i{ : if �f li )t Yi ai )E ai r: ii i s �i ii �F �i is ;i _. ;i • ;; ;,i A f "ti M :i. 'T :E N T' O R M A •T• :i. f N .SITE :: i RADDR(E::E::T' .: iii .'',:3 E PONDEROSA RO ifs DR E� ARCE: L 44042.202R SS- BROKANE WA 99206 PERMTT USE- (::;)PI...LLiiT:ING 11.;("TURF;:, PL..AT.•;;::: 001743 PLAT NrtME:r MYRON ESTATES NO 8 BLOCK- LOT= ?B ONE:::: !JR -'•3: `_"> ,•D I S T O- E: AF+:I::A:::: F•/A= F W):•D'T'H- I71=.F'TH-- F,iW�= 6( -*)0 Ili BLDGS= 1 0 DWELLINGS -1• WATER ):LST OWNER- S i:;i•i1 i:i:ST E.: R , ,:CCIT" T' PHONE- 509 927 2436 STREET- lii"131 E PONDEROSA DR ADHESION > F' C! I(A % WA 99 206 GON T•i 1 T NAME- AQUA MECHANICAL PHONE tJtJr'ITff:E•;= 509 487 Pi,.):ILDiHK NE TI.AC ,';: FRONT= ('A LEFT= NA RIGHT= NA REAR= NA r: •k• ii )i: h: ii k: ii i. c n ;i ;�; ;�: if J; �,::�• )i di" h• }i• 3i !•} h; it• .J� )t )i• '• ")i• dt' ie ii• ri• 3i• �i• k• #' ik 9k # ii• tF ")@ �:• # hi it •)i 3i• )r if• n :r. t, J,' > C:OMT R ACT. Cil=s::.: t:.)l:: UA L'iE: (:;!•i/ ART T. [.".AIRE R RG PHONE= 509 483 0635 S T•RE::E T :: 0407 E EUCLID AVE: i" �I)T)E•.'I`,'f,C:::: ,.SI-'(JI\Ai:dE WA 99207 ITEM D"r...i::RIPT'a i:' i ¢ f;,i(Ja`,N.I..I'_I.,f. FEE /')i''iOUN'T' — ...... PROCENSTMG FEE Y 25.00 T0TLFJ,',' 6100 BATH TUBE y i 6.00 9t # it #� # if i4 # fi ii ')t )t 9¢ tt• j; # ii iE # # fi:' tF ii x ;f ;{ J( It h h }(. E' fi % T SUMMARY � � H �f H ti �(� }i ii ii it )4 M # # 3i ik 1E !E � ii � # N r: #• N ,r PAYMENT DATf::RI C:Ft1�` O 1='fi`r`lii:NT ratiC1l1i;!!7 11/30/92 732 43.00 TOT'AL DUE= .f)�7'' "TLJTr�I._ PAID - 41-3-500' PERMIT TYPE 'PLUMBING PERMIT FEE AMOUNT r .00 ------------- 43.00 PROCESSED BY: WENDEL, GLORIA E''R):r•lTi:::t1 BY: WEtlf:iE l._, GLORIA ;i• #• #• # •N:" �i �:• r: ii •r: ii :K• i�: Ai• •r: •hi Jt• ii• ii• ir: �: )i. i�; ;i"si• :�,; ii• ;,i :a 3i• 3+: i4 AMOUNT E'r'iID AMOUNT..AMOUNT.._.._ OWING 43.00 _.... 00 . .-........_...,..........__. -------------- 43.00 --..._ ....................__— . - -- 4 3 . 0 0 .00 THANiC YOU AM PEC"HANICAL PLUMB'NG, HEATING, & AIR CONDITIONING East 2407 Euclid • Spokane, WA 99207 • (509) 487-0103 December 2, 1992 Please see enclosed copy of permit92010453, we are requesting refund as homeowner took out a permit for plumbing. Sincerely, Leann Gilmore Office Manager t -- �;NETW0RKI 2210 103 ®ISN 1 10M REFW ON P6*ff #92-010453 FOR 11123 E. PUCOM PER COPIES POM & LETTER W DLKTCATE PONT #92-010256 ATTACHED SELLER CERTIFICATION I, hereby certify that the materials have been furnished, the services SIGNED rendered or the labor performed as described herein or contracted TITLE for, and that the claim is a just, due and unpaid obligation, and that I am authorized to authenticate and certify to said claim. 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. CERT'AfICATION IIfiLJCE AD UNISTRATOR DATE 12/11/9-2 ❑ 1099 REO'D I D # 43.00 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