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1997, 10-08 Permit: 97008040 RefundPv# Dept REFUND .1, s MV100770017 •^ 030 BUILD E .PLAN VENDOR: A B CONSTRUCTION 4547 E DEER LAKE RD LOON LAKE Vendor Contact/fel WA 99148 SHIP TO: LGFS P SP Confirming Order MENT DOCUMENT E COUNTY AUDITOR BILL TO: PV MV100770017 Change Order# Bid ID Blanket# RCA VIA FOB: ACCTG. PERIOD: 10/97 COMMENTS: PO DATE BLDGJROOM: DELIVERY DATE: WAREHOUSE: ENTERED BY: PATRICIA EICKSTADT BUYER jVRCHASINGDIRECTOR:DONALD L. LABRECQUE COMM LNIt DIST: "E" DESCR1P77ON .5 . ky COMMODIYY10 s4 L-sliERlkCC(UNE <AAA / `, u'. SULRn." • -1jjfT PRICEm. " TOTALr PRICE 100A. ENTERED IN ERROR PERMIT NEEDE THROUGH L & I PRJS 97008040 SITE: 4510 E 7TH AVE. SPOKANE WA 99206 PAGE TOTAL: DISCOUNT TOTAL: FREIGHT TOTAL: SALES TAX TOTAL: PURCHASE ORDER VALUE: USE TAX TOTAL: GRAND TOTAL: 43.62 4.50 e 48.12- 0.00 8.120.00 0.00 0.00 48.12 0.00 48.12 LINENO' "FUND -AGCY• ORG ORG ACT .. OBI SB OBI REV SRC SB REV RPT CAT B5 ACCT IOB NO PAY THIS AMOUNT P/F 01 406 030 0008 02 N20 675 2420 2210 02 3700 TOTAL TO VENDOR: 43.62 4.50 48.12 SI ere minty CEIVTIFICATION w ty P CATIO rill u Mer • ty of perjury that .ullltlml feuds hare been budgeted for thh dabon the us node or labor performed as described herein or contracted for, that the dbin I. ort Sp! • County or fund agency Indicated above. Wt l m authorized to authenticate DATE 10/08/97 DATE 10/08/97 =LE...OFFICE ADMINISTRATOR ACCOUNTS PAYABLE TRAVEL CERTIFICATION 1 hereby m116 under penalty of perjury that this correct elmf movenminims lammed by m and that no payment has been marred by me en account thenal. SIGNED TITLE DATE 1 PAGE SPOKANE .COUNTY DIVISION OF BUILDING AND PLANNINt Y0?6 W =BROADWAY.' • SPOKANE, WA 9926070050''" ,.9 (509)456-3675 ( SITE INFORMATION PROJECT INFORMATION SITE ADDRESS: 4510 E 7TH AVE SPOKANE WA 99206 PARCEL NUMBER: 35232.4413 SUBDIVISION: CARNHOPE ADD LOT: 4 BLOCK: 15 20NE: UR -3.5 INSPECTOR: NONE WATER DIST: OWNER: WILLIAMSON, DORIS & ARTHUR PHONE: 509 534 2039 ADDRESS: 515 S MCKINNON RD SPOKANE WA 99212 PROJECT NUMBER: 97008040 ISSUE DATE: 10/03/97 PERMIT USE: RE -ROOF MOBILE HOME COVER APPLICANT: A B CONSTRUCTION PHONE: 509 233 2647 ADDRESS: 4547 E DEER LAKE RD LOON LAKE WA 99148 CONTACT: A B CONSTRUCTION PHONE: 509 233 2647 SETBACKS -> FRONT: N/A LEFT: N/A RIGHT: N/A REAR: N/A ENDER NAME: PHONE: ADDRESS: ( PERMIT(S) BUILDING PERMIT CONTRACTOR A & B CONSTRUCTION LICENSE #: ABCON==093KC NEW BUILDING DIM.= X SD FT= RE -ROOF R-3 VN STORIES TOTAL VALUE: S1,000.00 RESIDENTIAL VALUATION 35.75 RESIDENTIAL SURCHARGE 7.87 STATE SURCHARGE 4.50 TOTAL PERMIT FEE 848.12 loo°lo 1 1-4Q%-ecc 43.62,t gado4.6m 4 Ian - ec rev - 9, 75 3-00 PAYMENT SUMMARY PAYMENT DATE RECEIPT# PAYMENT AMOUNT 10/03/97 00009877 $48.12 TOTAL FEES AMOUNT PAID AMOUNT OWING $48.12 $48.12 $.00 ISSUED PERMIT BY: WENDEL, GLORIA 1 NOTES 401 ® / cit " /