1992, 04-22 Permit: 92002771 Reroof SPOKANE COUNTY-DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
,SPOICANG.WASHINGTON B92G0
(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 correctand authorize Sokane Conty to proceed with processing. In addition, I have read u understandm 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
PROJECT NUMBER= 92002771 ISSUED PERMIT DATE= 04/22/92 PAGE= 01
**************************** PERMIT INFORMATION ****************************
SITE STREET= 6715 E iiTH AVE PARCELO= 24534-1706
ADDRESS= SPOKANE WA 99212
PERMIT USE= RE-ROOF
PLAT4= 002810 PLAT NAME= WALLACE ADD
BLOCK= i LOT= 6 ZONE= TER DI%TO= E
AREA= OOOOOOOO F/A= F WIDTH= DEPTH= R/W=
0 OF BLDG%= i 0 DWELLINGS= i WATER DIST =
OWNER= FARRINGTON, MAUREEN PHONE= 509 922 2738
STREET= 6715 E iiTH AVE
ADDRESS= SPOKANE WA 992.12
CONTACT NAME= SEARS/DOREE PHONE NUMBER= 509 489 1170
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
******************************* BUILDING PERMIT ****************************
CONTRACTOR= SEARS PHONE= 509 489 1i70
STREET= P 0 BOX 3707
ADDRESS= SPOKANE WA 99220
NEW= REMODEL= X ADDITION= CHANGE OF USE=
DWELL UNITS= OCCU = = STORIES=
�
BLDG W A D = X SFi = %t-RINK[ER= N
REQ PARKING= OHANDfCAP= CRITICAL MAT= N
DESCRIPTION GROUP TYPE %Q FT VALUATION
----------- ----- ---- ----- ---------
RE-ROOF R-3 VN 4035.00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
-------------------------
-- ------
RESIDENTIAL VAL
-------%I EN A UATION Y 72.00
STATE SURCHARGE Y 4.50
COUNTY SURCHARGE Y 12.96
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT0 PAYMENT AMOUNT
04/22/92 2967 89.46
TOTAL DUE=DUE= .00 TOTAL PAID= 89.46
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
--------------- ------------- ------------
BUILDING PERMIT PERHIT 89.46 89.46 .00
------------- ------------
89.46 89.46 89.46 .00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DOMITROVICH , ROBIN
******************************** THANK YOU *********************************
,Q Pehiot-c11NVOICE RECAP AND DISBURSEMENT VOUCHER
PAY TO �0�z No. 463339
STORE NO. V079
STORE DATE / / 93
SALESCHECK JOB I.D.NO.OR
AMOUNT ALLOCATION OF EXPENSE—FOR INSTALLATION OFFICE USE
CUSTOMER'S NAME NUMBER WORK ORDER NO. DUE ACCOUNT DIV. CONTRACTOR MEMO
CONTRACTOR NUMBER NO. ADJUSTMENT ACCT. ACCT. EXPENSE SELLING
2�I � _5(/((3602-- G 8ci
ke,00(
I certify that the installations listed above have all been TOTAL
completed satisfactorily in accordance with the speci AMOUNT TOTALS 87
fications furnished me. 477OK TO PAY PAYING UNIT NO.
(AUTHORIZED SIGNATUR
/ PAYING
CHECK NO. UNIT NAME
(CONTRACTOR'S SIGNATURE) (DATE) (If Different)
14489(See Bul.0-187 Part II Supp.8) REV.3/91 SEARS FORMS MANAGEMENT
ACCOUNTING COPY