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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