1992, 11-02 Permit: 92009581 Reroof SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 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,oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROJECT T NUMBER= 92009581 ISSUED PERMIT DATE= i i /02/92 PAGE= 01
**** 4**3434* x***** •**** *** PERMIT INFORMATION ***** ****•*** *• *A•;i •* • •*xx•••
SITE STREET=T-• i0518 E 13TH AVE F'ARCE#...0- 45:204 2206
ADDRESS= SPOKANE:: WA 99206
PERMIT USE= RE"-ROOF
PLATO= 002704 FLAT NAME= UNIVERSITY PLACE
BLOCK::: 21 LOT= ZONE= UR-3.5.5 DI ST4:: E.
AREA= F/A-: F WIDTH= 100 DEPTH= 142 Rt/'W:::
OF Irit..D(YS::: 4 DWELLINGS= i WATER DIST =
OWNER::: SANDRES . DEL..EtERT PHONE::: 509 928 0746
STREET:- 10518 E 13TH AVE /
ADDRESS= SPOKANE WA 99206
CONTACT JAaE: SEARS PHONENUMBER= 509 482 5685
BUILDING SETBACKS : FRONT= N/A LEFT= N/A RIGHT:::: N/A REAR:::: N/A
3434****3(3334*34*3434***•***343433434***•3434 BUILDING PERMIT
•**3r:*h**•*******34- *' *****34343434
CONTRACTOR::: SEARS PHONE.::: 509 489 1170
SSTREET= P O BOX _r'0»r
ADDRESS=:: SPOKANE WA 99220
NEW:::: REMODEL.:::: X ADDITION= CHANGE UNITE=
USE=
DWELL.. ITS:- Ocict.IF'. L..D:: BLDG HGT::: STORIES=
REQ PARKING:::: O HANDICAP::: CRITICAL_ MAT:- N
DESCRIPTION GROUP TYPE SQ. FT VALUATION
---------
RE—ROOF R—3 VN 1555.00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
RESIDENTIAL VALUATIO Y ;a :.00
STATE SURCHARGE Y 4.50
RESIDENTIAL SURCHARGE
? h i 4 4 k 4 Pr 3 31 i H * e 3 { ti 4 A 4$ 4 3 k 3Nk A3PAYMENT S# MMfFv x#3 »
3 *ir x 4 4 4 4 3a* 4 4 k> 4 4 4 t r i 34
PAYMENT DATE RECEIPTO PAY'ME.:N T AMOUNT
11 /02/92 9744 48. 16
TOTA#_. DUE:::: .00 TOTA#_. PAID:- 48. 16
PERMIT TYPE FEE AMOUNT AMOUNT F'AII) AMOUNT OWING
BUILDING PERMIT 48. 16 48:. 16 .s00
48. 16 48. 16 .00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DOHITROVICH, ROBIN
34a •34*34.34.34•: 34* •**3434•x:34.3;•*.34• :3434*;:•34.34.343434 THANK YOU *****t***34.34*••*•****3414**343434*****34.3E34**
/;% NVOI E RECAP AND DISBURSEMENT VOUCHER
/PAY TO ��//. �,/_r i/ �/�"i %� ii! �i.� �,�
i / N42
39
STORE NO. __70: i I
MI'
STORE DATE �u'`,// V1,
I OUNT ,
�I_ ALLOCATION OF EXPENSE—FOR INSTALLATION OFFICE USE
SALESCHECK 1. JOB I.D.NO.OR I
CUSTOMER'S NAME NUMBER WORK ORDER NO. I DUE ACCOUNT DIV. I 11 CONTRACTOR MEMO
CONTRACTOR NUMBER NO. I ADJUSTMENT ACCT. ACCT. I EXPENSE SELLING
X0 '/6 40,i0, / ,sia,,,Lig7kc)__ 9 aR Qeo/ v /w
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ioSi8 ' /3 le,A.
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('',geo r I � _ - 9 oa7) H
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I certify that the installations listed above have all been TOTAL
completed satisfactorily in accordance With the sped AMOUNT '4 I) TOTALS /h
fications furnished me. // e — • O`
OK TO PAY PAYING UNIT NO. /If)7 l
(AUTHORIZED SIGNATURE)
PAYING
CHECK NO. UNIT NAME
(CONTRACTOR'S SIGNATURE) (DATE) (If Different)
ii
14489(See Bul.0-187 Part II Supp.8) REV.3/91 SEARS FORMS MANAGEMENT
ACCOUNTING COPY