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1991, 02-26 Permit: 91000702 Garage SPOKANE COUNTY DEPARTMENT OF BUILDINGS W. 1303 BROADWAY AVENUE SPOKANE ,YASH!NGTON 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 issu ce of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to give authority to violate or cancel t ro isions of a tate or regulating construction,or as a warranty of conformance with the provisions of any state or local laws regulating construction. SIGNATURE OF APPLICATION Z.— 2 / �J// OWNER OR AGENT .1.--x DATE v . . ......... . -CONTACT NAME. :: . i i ) RAY ARN'4O t. _ .... _- ... PHONE i1 C,#F"i;':::: •Efi nt.: SE.?..B t t FR.+: : i! 2 j!r,! ISP R J!.1t +.•A:'!+-' I:**.•*,* k.'!' !t!t_o.>,..;.,•.;ie:.yy.**-•x•.'ti••jt; <T) '.: {j ''} ..R . r e ,!•t ! h n .jl?:9t'!t•Yi•j.•ti•-Nr s+t it:-if:31.-K.*:A. S'11:.jai:': .y .. vii: DWELL .::. STORIES,,, CHANGE T2 2 . ..1.{...... _ ? ?::.?! .. .:. ... - 72 ,00 SURCHARGE if(2N -'k ? -)....;,:p.:::: q:.j}.*.:.:-:.-:yj..}j.it::'.:.j,:•.ij.:,(.:'41:.i.:.iy::,u,'.::y::yj.•:..iy::: .... ' M,_' tl € -S.'i,:i`` I"?(-)?:;!•` y;.jy.* ':'!$i't•:yi iui'jyr•jt'•a''!. :. :...jt.'!:3f;g{-;u}-.'yi.p:.t.:yj••P"P:.!. .... '{ 22-NT 7.+tf l T Y _. ,.;:..: . :.::.,. TOTAL PATD'' O8, 07 . M...11LT• TYPE FEE AMOUNT AMOUNT FATD AMOUNT nwiw..., :lF .. k *..)1:•*..: ...:.::... !:•..!.!. .. :'r•j':=. :P:':.$1.• ... . '.'°:'.. .. .:':ly:•i:•3'. »'P!if:9yi!+r'Rt?S•}t p. :t ; !!;s..yy:: .,{.:. ::i{. i -or* r" r SPECIAL CONDITION CHECKLIST Project Address: ___ _ __ Project#__ _ — _—Use: Dept: Date: Condition: Init: Appr: (in) (out) Dept.of Bldgs. ---_—_-- --._ — Special Insp.Final Report_-- Hydrant( ) Lock Box — --- Engineer's _ — RID/CRP Easements- - Road Plans/Improvements — Bonds Planning — — Bonds Utilities _ Double Plumbing — ULID Other "****"*****************"*******THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY**************************"*** Date received for C/O processing: _— _, Plans pulled for final processing: Temporary C/O issued: _.Certificate of Occupancy issued: Office file review by: _— Date: Filed insp finaled by: . Date: Ninety days after 0/0 issuance: Owner/contractor called regarding the return of plans: _._ __ — ____. Date: Plans returned: Received by:_ — -----._.__--------------------_-_-_-- No response from owner/contractor-plans destroyed: j SPOKANE COUNTY PAYMENT VOUCHER 129327 ttiENDOR �' DATE 1 /1 II ,' COWL 'ITS': AGENCY 7,,,-)0c:. ,:.N: p ;n„s1,NT NAME 4” RAI ARNOLD t NAME AUDITORS STAMP ADDRESS FAST 15 ,:2 1.2T;1 AVENUE I r i s "F? i r r r;nr�2T . ' ' Inlr�iitii 1, all,J. t�OA _ . *--... .i I. - ,,� �r ,. ei'° ,:^',0'.r II 11" 4. ...=,-.7,..i- `II 11 1=" -- ori° .1. 14 li [_Pr ilk . I I IrE ACCOUNT DISTRIBUTION,ORIGINATING ENTITY(ALL VOUCHER TYPES) - 0 1099 REQ'D ID# LINE VENDOR ORGAN- SUB REV SUB JOB REPT : BS ®ESCR{PTIDN AMOUNT FUND AGENCY ACT OBJ NO.' INVOICE NUMBER RATION OBJ SOURCE REV NUMBER CATEG ACCT 1 91-00070? C 'DODO 2210 02 REFUND) N? 575 2700 1 41.50 DETAIL DESCRIPTION I, the undersigned do hereby TOTAL 1 -"_ REFUND ON PERMIT #910'::0702 'FOR 15922 EAST 12TH AVENUE - certify under penalty of perjury 71.52 GARAGE PROJECT CANCELED PER COPIES OF LETTER .1A PERMIT that sufficient funds have been budgeted for this claim, the ma- TRAVEL CERTIFICATION 1 $72.00 terials have been furnished, ser- I hereby certify under penalty of perjury 11.52 vices rendered or labor performed that this is a true and correct claim for $n3 52 ,X 30°', _ $5:5.82 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 5 $1.50 X 10174 = t.5O and unpaid obligation against on account thereof. Spokane County or fund agency SIGNED TOTAL S71 .32 indicated above, that I am autho- rized to authenticate and certify TITLE INTRA-GOVERNMENTAL VOUCHER to said claim. DATE SELLERS ACCOUNT DISTRIBUTION ORGAN sue REVENUEOFFSET EXAMINED and ALLOWED FUND AGENCY RATION ORG ACTIVITY SOURCE REV JOB NUMBER CARTED REQ©TES. N. CERT IF TI.Oli_._ DATE 19 _______ \ SIGNED ' CHAIRMAN SELLER CERTIFICATION I,hereby certify that the materials have been furnished,the services SIGNED TITLE OFFICE ICE A5'1 I N.I S TRATO5 MEMBER rende ed or the labor performed as described herein or contracted fcirncl that the claim is a just,due and unpaid obligation,and that TITLE 10/17/91 an autn'Jrized to authenticate and certify to said claim. DATE DATE MEMBER i - -14 1 .l ` SPOKANE COUNTY PAYMENT VOUCHER NUMBER 12 9 3 2 7 VENDOR DATE 10./17191 CODE MISC 1 t'; ', � , ,fir F�`;, ' ,2.1f..-'-: s ry� ti } AGENCY CODE ENFORCEMENT TED RAY ARNOLD is .,A^, �, , ,Ao> NAME NAME t r"" ' 'l *,,) r'1}+,'`�`, AUDITORS STAMP ADDRESS EAST 15022 12TH AVENUE l '1° : .....E!..... � • i ,;t, VERADALE, WA 99037 '*A 1 F l I'' 1 1., { i ' .1J1 , �< < It the . ill ��'� 11.11— j.,, Ii iI 6 li .6. 'ice ; 11 r LP' ,L 1.117c ACCOUNT DISTRIBUTION, ORIGINATING ENTITY (ALL VOUCHER TYPES) ❑ 1099 REQ'D ID# .;, 3 a ,4 'ht t, 4'. \1",,�vE':�, ..dv"sW: 'sg, Pr.1s q ''' 2e , � 4 UNE VENDOR ORGAN- SUd, REV rSUB �u� EPT . Y RI?fION� ' AMOUNT NO, INVOICE NUMBER FUND AGENCY IZATIOM ACT OB,! OBJ. SOURCE. REV! ,,',: NUMBER,. CATEG AC 74.,41,,--,,y . "' 1 91-000702 406 030 0008 2210 02 REFUND 66.82 2 iiN20 675 3700 i, 4.50 DETAIL DESCRIPTION I, the undersigned do hereby TOTAL 1 -2 REFUND ON PERMIT #91000702 FOR 15022 EAST 12TH AVENUE - certify under penalty of perjury 71.32 GARAGE PROJECT CANCELED PER COPIES OF LETTER & PERMIT that sufficient funds have been budgeted for this claim, the ma- TRAVEL CERTIFICATION 1 $72.00 terials have been furnished, ser- I hereby certify under penalty of perjury 11.52 vices rendered or labor performed that this is a true and correct claim for $83.52 X 80% _ $66.82 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 2 $4.50 X 100% = 4.50 and unpaid obligation against on account thereof. Spokane County or fund agency SIGNED TOTAL $71.32 indicated above, that I am autho- rized to authenticate and certify TITLE INTRA-GOVERNMENTAL VOUCHER to said claim. DATE SELLERS ACCOUNT DISTRIBUTION EXAMINED and ALLOWED A Y.,O ei* sue ACTIVITY REvEN ii -1'.' "41z" "a c.t RIND. J IZATION ORG SOURCE- °,' , ',, ,� ^. A�,'' --$41$4---,,,o;1L, ,,,, 5,` SIGNED DATE 19 ice'! N , CHAIRMAN SELLER CERTIFICATION - I,hereby certify that the materials have been furnished,the services SIGNED TITLE OFFICE ADMINISTRATOR MEMBER rendered or the labor performed as described herein or contracted TITLE F.:.- „�., .5....,t.l,.,....i..,Ic»�:io7 sl::,�nr..x,,•.. {nhlin9f�nn [t n.i fh7t ...___ 1n ti-/ /nt -3- -r.4- eck,vti gAlvit27- i>ici- 0A becclei A}7'- _,/ R/41411-'6 gecM,re_ 1---&. I'd 9 1/ / A 0 I--o 0 4A,Ad ol"" A-- --4 -- 4, I e 5. roDec4 yer1022___ ter/J.1 i I /14,7 I.Zi • ....ilue1/4.iti _I_ ' IRA. CONSTRUCT! N TE:D RAY ARNOLD iOWNER) E. 15022 12TH AVENUE VERADALE,WA 99037 t509) 922•5409 e• C-''' ' ! cqk'-ii (''' M t 0/0/41 i - Z r-