2001, 06-13 Permit: 01004262 Refund.r
Project Receipt Summary Wednesday, lune 13,1001 Page lojl
Address 2404 S REES LN
PROJECT#: 01004257
SPOKANE WA 99206
PROJECT#: 01004262
Owners Name: HAYDEN HOMES
Phone: (509) 994-4691
Address:- 3327 W INDIAN TRAIL RD #232
Phone: (509) 994-4691
SPOKANE, WA 99208
Occupant:
Phone:
Applicant: HAYDEN HOMES
Phone: (509) 994-4691
Use: RESIDENCE W/GARAGE - NATURAL GAS
Phone: (509) 994-4691
Application Date: 6/4/2001
Permit Issue Date: 6/11/2001
Receipt Nbc 4214 Transaction Date/Time:
6/11/2001 4:08:51 PM
Acct Account Transaction
6/11/2001 4:07:32 PM
Description
Total Due Amount Paid
00120 RESIDENTIALPMTS P
$620.43 $620.43
00150 STATE SURCHARGE P
$4.50 $4.50
00410 MECHANICALPMTS P
$97.00 $97.00
P0120 RESIDENTIAL PMTS P
$247.30 $247.30
00610 PLUMBING PMTS P
$90.00 $90.00
PROJECT # 01-4262
Overpayment — Reimbursed with PeopleSoft Voucher # 00091801 (pap).
Project Receipt Summary Weds day, June 13, 1001 Page lof]
Address 2516 S REES LN
PROJECT#: 01004262
SPOKANE WA 99206
.. Owners Name:- HAY.DEN-MOMES -'
Phone: (509) 994-4691
Address: 3327W INDIAN TRAIL RD #232
SPOKANE, WA 99208
Occupant:
Phone:
Applicant: HAYDEN HOMES
Phone: (509) 994-4691
Use: RESIDENCE W/GARAGE - NATURAL GAS
Application Date: 6/4/2001
Permit Issue Date: 6/11/2001
Receipt Nbr: 4213 Transaction Date/Time:
6/11/2001 4:07:32 PM
Acct Account Transaction
Description
Total Due Amount Paid
00120 RESIDENTIAL PMTS P
$734.91 $734.91
P0120 RESIDENTIAL PMTS P
$292.94 $292.94
00150 STATE SURCHARGE P
$4.50 $4.50
00610 PLUMBING PMTS P
$108.00 $108.00
00410 MECHANICAL PMTS P
$65.00 $85.00
PROJECT # 01-4262
Overpayment — Reimbursed with PeopleSoft Voucher # 00091801 (pap).
Vendor ID HAYDENTE01
Voucher ID 00091801
Rel Vchr ID
Dept ID
VENDOR:
Hayden Enterprises Inc
2622 SW Glacier Place Ste 110
Redmond OR 97756
,ndor Contact/Tel
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO:
BILL TO:
PAGE 2 OF 2
046
INV# 01-4257 & 4262
ENTERED DATE: 06/12/2001 PO DATE: BUYER:
ENTERED BY: Patty Eickstadt PURCHASING DIRECTOR: BELA G. KOVACS
LINE N0. T DISTRIB LINE ACCOUNT I FUND I DEPTID PROGRANIT CLASS RPT CAT ''I BDPER-1 PC UNIT PAY THIS AMOUN"
PROJECT I ACTIVITY RES. TYPE I CATEGORY I SUB CAT I AM UNIT I PROFILE I ASSET FLG I ASSET ID
Comments: 100 % REFUNDED = PRJ # 01-4262 = SITE LOCATION OF: 2516 S REES LN.;
SPOKANE WA 99206 & PRJ# 01-4257 = SITE LOCATION: 2404 S
REES LN.; SPOKANE WA 99206.
RECEIVING CERTIFICATION
Materials noted in yuant'ny ° have been received hi gond condition or
contracted for,
11
SIGNED
PAYMENT CERTIFICATION
I, the undersigned.do-her'eb`y ceRify`[n7der natty of perjury that surficient funds have been budgeted
for this claim, a materials have been furnis d, vices rendered or labor performed as described
her ' Vr"Cdhirar Md for, that the clat is a ju , due an unpaid obligation against Spokane County
or fund age digaled above, thorized to thenticate and certify to said claim.
SIGNED
DISCOUNT TOTAL:
0.00
FREIGHT TOTAL:
0.00
SALES TAX TOTAL:
0.00
SUBTOTAL:
70.00
USE TAX TOTAL:
0.00
GRAND TOTAL:
70.00
TOTAL TO VENDOR: 70.00
TRAVEL CERTIFICATION
1 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 6/12/01 TITLE ACCT TECH 4 DATE 6ZJ210— TITLE OFFICE ADMINISTRATOR DATE TITLE
Vendor ID HAYDENTE01
Voucher ID 00091801
Rel Vchr ID
Dept ID
VENDOR:
Hayden Enterprises Inc
2622 SW Glacier Place Ste 110
Redmond OR 97756
Vendor Contact/Tel
SPOKANE COUNTY PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO: BILL TO:
PAGE 1 OF 2
RC#
INV# 01-4257 & 4262
ENTERED DATE: 06/12/2001 PO DATE: BUYER:
ENTERED BY: Patt Eickstadt PURCHASING DIRECTOR: BELA G. KOVACS
LINE NO. DESCRIPTION I ITEMID I QUANTITY UNIT UNIT PRICE I EXTENDED AMOUNT
PO# I CHG ORD# I PO LINE# I PO SCHED# CONTRACT#
1 100% - REFND'D OVERPYMNT W/CK 1.0000 EA 0.00 35.00
0 0 0
2 OVERPYMENT BY CK 1.0000 EA 0.00 35.00
0 0 0
LINE NO. I DISTRIB LINE I ACCOUNT I FUND I DEPTID I PROGRAM CLASS I RPT CAT I BDPER F PC UNIT I PAY THIS AMOUNT
PROJECT I ACTIVITY I RES, TYPE I CATEGORY SUB CAT I AM UNIT I IPROFILE I ASSET FLG I ASSET ID
—
1 1 36981 406 0300008 2001 PROJA
BACE 240 REFND N
2 1 36981 406 0300008 2001 PROJA
BACE 240 REFND N
35.00
35.00