1995, 07-20 Permit: 95005372 AC SPOKANE COUNTY DEPARTMENT OF BUILDINGS y-
. WEST 1026 BROADWAY • SPOKANE,WA 99260-0050
(509) 456-3675
SITE INFORMATION PROJECT INFORMATION
a
SITE ADDRESS: 16426 E RIVERSIDE AVE ffi PROJECT NUMBER: 95005372 ISSUE DATE: 07/20/95
VERADALE WA 99037
PERMIT USE: AIR CONDITIONER
PARCEL NUMBER: 45134.1433
APPLICANT: STURM HEATING, INC
SUBDIVISION: VERA,REPLAT OF BLOCK 13 PHONE: 509 325 4505
LOT: 1 BLOCK: 1 ZONE: UNK I ADDRESS: 204 E INDIANA AVE
SPOKANE WA 99207
INSPECTOR: REED OCKEY CONTACT: STURM HEATING, INC PHONE: 509 325 4505
WATER DIST: SETBACKS -> FRONT: N/A LEFT: N/A RIGHT: N/A REAR: N/A
OWNER: FISHER, NEVIN LENDER NAME:
PHONE: 509 926 1399 PHONE:
ADDRESS: 16426 E RIVERSIDE AVE ADDRESS:
VERADALE WA 99037
1
-----------------
f PERMIT(S)
CONTRACTOR
STURM HEATING
LICENSE #: STURMI*210OF
HEAT PUMP OR A/C 0-5 TO 1
PROCESSING FEE 25.00
TOTAL PERMIT FEE $37.00
PAYMENT SUMMARY NOTES
PAYMENT DATE RECEIPT# PAYMENT AMOUNT
1
07/20/95 00006484 $37.00 i
TOTAL FEES AMOUNT PAID AMOUNT OWING
jry
$37.00 $37.00 $.00 �� tt
ISSUED PERMIT BY: WENDEL, GLORIA 1
I
Pv#
Dept
VENDOR
�, �`..: t.NG INC
2C4 E. INriT i ANA AVENUE
99207
Vendor Contact/Tel
LGFS PAYMENT DOCUMENT
SPOKANE cowry AUDITOR
SHIP TO:
Cordirn®q Order
BILL TO:
Change Order #
Bid ID
Blanlaet#
RC#
v1#
FOB:
ACCTG. PERIOD: " / 2
COMMENTS:
PO DATE:
DELIVERY DATE:
ENTERED BY:
BLDG/ROOM:
WAREHOUSE:
BUYER
PURCHASING DIRECTOR.
COMM LN#
DESCRIPTION
COMMODITY NO
REF ACCT LINE
QUANTITY
UNIT
UNIT PRICE
TOTAL PRICE
RJ K' _ .
100% REFUND -PERMIT ENTRY ERROR
SYSTEM VOID
PAGE TOTAL:
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
PURCHASE ORDER VALUE:
USETAX TOTAL:
37.00
0.00
0.00
0.00
37.00
0.00
1.,IN1r NO.
FUND I AGCY I ORG
SB ORG 4 ACT
OBI
SB OBI
REV SRC
SB REV
RPT CAT
BS ACCT I JOB NO.
PAY THIS AMOUNT
P/F
'OTAL TO VCNf0R :
RECEIVING CERTIFICATION
Materials noted in quantity / have been
received in good condition or contracted for.
SIGNED
TITLE
DATE
PAYMENT CERTIFICATION
I, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim, the
materials have been furnished, services 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 1 am authorized to authenticate
and certify to said claim.
SIGNED TITLE
DATE
DEPARTMENT 2
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 PAGE