1990, 06-22 Permit: 90002917 AC SPOKANE COUNTY DEPAR"MENT OF BUILDING AND SAFETY
W. 1303 BROADWAY-AVENUE
SPOKANE,WASHINEGTON 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, I 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 construed to
give authority to violate or cancel the provisions of any state or local law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
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SPOKANE COUNTY PAYMENT VOUCHER 11361,9
VENDOR
CODE DATE 327190
AGENCY
NAME ANNER FURNACE & FUEL CO. , INC. -
I TE
0 . BOX 4346 AUDITORS STAMP
ADDRESS .
SPOKANE WA 99202 . X �„ ;;;T t-, -,,
ill:°�*II b 1_~_n,_�p,� '.ei i i 1�=
ACCOUNT DISTRIBUTION,ORIGINATING ENTITY(ALL VOUCHER TYPES) 0 1099 REQ'D ID#
LINE VENDOR ORGAN- SUB REV SUB JOB REPT BS DESCRIPTION AMOUNT
NO. INVOICE NUMBER FUND AGENCY RATION ACT OBJ OBJ SOURCE REV NUMBER CATEG ACCT
1 #90002917 2210 07 29. r u
DETAIL DESCRIPTION
' 1 I, the undersigned do hereby TOTAL 29. 60
801 REFUND FOR PERMIT ## ISSUED 6/2190 FOR certify under penalty of perjury
S 1321 WOODRUFF TOAD, SPOKANE, APPLICATION WITHDRAWN that sufficient funds have been
JOB AANCELLED 80% X 37 . 00 = $29. 60 budgeted for this claim, the ma- TRAVEL CERTIFICATION
terials have been furnished, ser- I hereby certify under penalty of perjury
vices rendered or labor performed that this is a true and correct claim for
as described herein or contracted necessary expenses incurred by me and
for, that the claim is a just, due that no payment has been received by me
and unpaid obligation against on account thereof.
Spokane County or fund agency SIGNED
indicated above, that I am autho-
rized to authenticate and certify TITLE
INTRA-GOVERNMENTAL VOUCHER to said claim. DATE
SELLERS ACCOUNT DISTRIBUTION
SUB OFFSET EXAMINED and ALLOWED
FUND AGENCY ORGAN SUB ACTIVITY REVENUE REV JOB NUMBER RPT R CEIVAB S
R )
RATION ORG SOURCE CATEG. T
C - lw.. ON--=>-`- _...DATE 19
SIGNED '�� , r-...) CHAIRMAN
SELLER CERTIFICATION }_-
I,hereby certify that the materials have been furnished,the services SIGNED (�7lTLE I C E AD M I N I S T'A T O R MEMBER
rendered or the labor performed as described herein or contracted
for,and that the claim is a just,due and unpaid obligation,and that TITLE
I am authorized to authenticate and certify to said claim. DATE DATE 8/27/90 MEMBER