1992, 09-25 Permit: 92008051 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 tharthb iformation 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 pr cessing. 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
PROJECT NUMBER= 92008051 ISSUED PERMIT DATE= 09/25/92 PAGE= 01
1;•**3R.•a:•a•3{• •***3ia•3i•***.3{•3{•3{•3i3E3i3{•3i3G••r.•3':• PERMIT INFORMATION ****************************
SITE S T'RE.I T- 12806 r 15TH AVE PARCEL-4= 45223.2008
ADDRESS= SPOKANE: WA 99216
PERMIT USE::= RE—ROOF
PLATO= 001847 PLAT NAME= OPPORTUNITY TERRACE ESTATES
BLOCK= 3 LOT= 8 ZONE= SFR I`,I STO= F'
AREA= F/A=E /A= F WIDTH= 8F3 DEPTH= i i Fti14= 50
:n
OF DG '` DWELLINGS= 1 WATER DIST
OWNER- JENNEN CHERYL.. PHONE= 509 928 5582
STREET= 12806 E -15TH AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= SEARS PHONE NUMBER= ='O9 482 5685
BUILDING SETBACKS : FRONT-: N/A LEFT= N/A RIGHT= N/A REAR= N/A
........
)i•3E 34 3r 3F:R}�•#�3M 3i 3i•3e 3�•#r 36 3r 3k ii•3t•3'•k 3r 3r a 3{#3i#t•#k•3t• BUILDING ' ;. ?1" n 3i•3k 3c 313r 3e 3t•*3r ii 3!•3(•3e 3t 3t 3i 3i#�•**3r 3e�•a m•n
CONTRACTOR= SEARS PHONE= 509 489 1170
STREET= P 0 BOX 3707
ADDRESS= SPOKANE WA 99220
NEW= REMODE::i...-: X ADDITION-- CHANGE OF USE=
DWELL UNIT 5== OCCUF'. I D'= BLDG HGT= STORIES=
BLDG wI X r := °` O FT= SPRINKLER= N
REQ PARKING=:: OHANDICAP== CRITICAL MAT= N
DESCRIPT.I.ON GROUP TYPE: SCS FT VALUATION
RE.'-'ROOF R_-3 VN 45574.00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION Y 72.00
STATE: SURCHARGE r` 4.50
RESIDENTIAL SURCHARGE.-:: Y 1 :.96
*3ir• •**i:•3R3i3!-3c•Yr3#•3t•3+:3(•ii3ia•3ck*3t•3i•3{•3k3E3k3Eri•* PAYMENT SUMMARY *34313E*3k3i**is3s•**3i**•h:•k•3i •a3c*n:*3C•*3i
PAYMENT DATE. RECEIPT;: PAYMENT AMOUNT
09/.2.5/'92 81 80 89.:46
------------
TOTAL.. DUE=:: :.00 TOTAL. PAID= 89.46
PERMIT TYPE FEE AMOUNT AMOUNT F'AID AMOUNT OWING
BUILDING "I•PE:RMIT 89. 46 89.4 , 00
89.:46 89. 46 00
PROCESSED BY : DOMITROVICH, ROBIN
PRINTED BY : DOMITROVICH, ROBIN
***n*x r t{ * u n 3(3i•n ri 3•a r>t: ii 3':34 3G 3i 3{3{3k THANK T l.7... 3c*3j k:3i: 3E 3i 3i 3i ik 3C a k 3': 3r ii a*3R*a 3r 3k*3i 3h 3{3c 3k
,/�,�I ICER CAP AND DISBURSEMENT VOUCHER R�
PAY TO /I.LI� / _ _�i ri `./ i No. 780468
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STORE NO. VZ-2.77 , ��
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STOREft Bele Ca - DATE 9-7/--9c — 1
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
9-- // I
/206 f As-7 iaa `'
1
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I certify that the installations listed above have all been TOTAL . �' Q
9 (6
completed satisfactorily in accordance with the speci AMOUNT TOTALS o
fications furnished me.
OK TO PAY PAYING UNIT NO.
(AUTHORIZED SIGNATURE)
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
I