1992, 10-08 Permit: 92008597 Plumbing Reversal 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,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= 92008597 ISSUED PERMIT DATE= 10/08/92 PAGE= Oi
**************************** PERMIT INFORMATION ****************************
SITE STREET= 128.18 E 23RD AVE PARCELO= 45272.3005
ADDRESS= SPOKANE WA 99216
PERMIT USE= PLUMBING ALT.
PLATO= 00.1223 PLAT NAME= HILLCREST ACRES 2ND ADD
BLOCK= 4 LOT= 5 ZONE= UR-3.5 DISTO=
AREA= F/A= F WIDTH= 81 DEPTH= 216 R/W= 50
4 OF BLDG'S= i ; DWELLINGS= i WATER DIST = SPOKANE SUBURBAN
OWNER= GORDON, MICHAEL PHONE= 509 922 1705
STREET= 12818 E 23RD AVE
ADDRESS= SPOKANE WA 99216
CONTACT NAME= DUAINE PHONE NUMBER= 509 924 5485
BUILDING SETBACKS : FRONT= NA LEFT= NA RIGHT= NA REAR= NA
*x**x*xxxxxxx*x*************x PLUMBING PERMIT ******xx*******xxxx*x*******x*
CONTRACTOR= COURCHAINE CONSTRUCTION PHONE= 509 924 5485
STREET= 16402 E VALLEYWAY
ADDRESS= VERADALE WA 99037
•
ITEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE 11' 25.00
MISCELLANEOUS i 6.00
MINIMUM FEE ADJUSTMENT Y 4.00
******************************* PAYMENT SUMMARY****************************
PAYMENT DATE RECEIPT; PAYMENT AMOUNT
10/08/92 8724 35.00
TOTAL DUE= .00 TOTAL PAID= 35.00
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
PLUMBING PERMIT 35.00 35.00 .00
__ -35.00 35.00 .00
PROCESSED BY : BARRY HUSFLOEN
PRINTED BY : BARRY HUSFLOEN
*x***x******x******************* THANK YOU *x**********x***xx*****x***x*****
SPOKANE.COUNTY�.�PAY.MENTNO.UCHER NUMBER 1i-cull
VENDOR REFtA� rr ,I:� , k DATE ;
11j4/92
CODE :. u �� ,SLi s. 5
• '' ., f. AGENCY CODE DERCEMENT
:CONSTRUCTION is
•t b�'4¢ (� '� �'sr,�'�r , v,:,�.„�,... NAME
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(XTUItCHAINE:CONSIR �, �, ,� '�����, ~� .«x` � •
•
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NAME • ,; t� ': t;• , .`'4.'. i7�elf yi to • AUDITORS STAMP
ADDRESS 16402 EAST VALLEYVJAY arks '” ;'r,...
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SPOKANE, WA 99206 • ".�..'-s'? ;. ' .,,,,,�EnNit-t I , ; i`,, . '
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ACCOUNT DISTRIBUTION,ORIGINATING ENTITY(ALL VOUCHER TYPES) [] 1099 REO'D ID#
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.r u 1. .J"r ::', S ,S. _ r%1•' JO 's .,-+= x'$EP7:A .B4,:t�r 7 w• r A': ;r 1,irk'_.;.,.t; AM6-egifie r .:;�,:
r.. J;..u..�•..�� •? x s h r( .. r.t,,,a�✓. � REV. RAN �f'v:• ..,._,,:t;�., v•, _,s,a,:, ...4•-, .'k`F!":. h�',�''> DE pIPTIOf�'- ,5��. �( ,,. .y• .:ro.,y..,�,tn
,Y,.: V it r••.t•t . ..t• J., ...St�B, : w::• v.,S. .r . ^ e:. +,. •.,;u. :k?.,t; :.. y., .'ti+T�' •)��.�- v „4,,, Tf.Z� !r
,-. ;� .ORGN �,� ti :>.: ,.5+ r•.r, �. �.,, t� 7� t3..
VE0., a.t , .;' AGT BJ, gi r UtilgER.,• C fiEG: t ', :3.,.,34- '$:.s�.•:,'3e:a:i......r�.a,;..t,.,y,t."Sir t$147^eittPhtT�'`r.,s. .e,,...
LINE ,; •Ft > UND .AGENCY- RATION} Q r �Qg,]� .SOURCE, „.'R�V.M11 v� L N.,.,,,a....-ri�+�+,.w�._�.. -.a.,,.,��.,7.ar.n
•NO'; INVOIGENpMBER o'.. :::;..,,-s.:4..:.: •... ,Fit‘:,;119.k1,:4,., i ., .. ,,: a.d... �. . ,. ...
1 406 • 030 0008
2210 02; 16.00
2 401 436 0000
4240 64.00
• ?210 03 56.00
3 • 406 030. 0008 . ,
•
DETAIL DESCRIPTION TOTAL 136.00,
1& 2 PERMIT 92-008690 FOR 30.26 SOUTH RAYM CIRCLE'AND.PERMIT #92-0092-007276 I, the' undersigned : doo hereby
• certify.under penalty' of perjury.
FOR 2621 SOUTH HOUK-CT AS FOLD. 1S: 4h rtt.sufficient funds have been TRAVEL CERTIFICATION
$10.00 X 80% = 8.00X.2. $ 16.00 • 'budgeted:for this claim, the*ma=
•
• $40.00 X 100% = 32.00 X 2' = 64.00 , terials,have been furnished, ser- I hereby certify under penalty of perjury
#92-007277 FOR 2621 •S UTH HOUK CT AND #92-008597 FOR 12818 EAST Vices rendered or labor performed. :• that this is a true'and correct claim for
PERMIT •as described herein or contracted necessary expenses incurred, by me and
23RD AVE.AS FOLl. rlS •• for;that the claim is.a just,-due that•no payment.has been received by.me
•
$35.00 X 80% = 28.00 X 2 $56.00 • ' 'and unpaid Obligation against ' on account thereof.
PER COPIES OF PERMITS AIS LETTER ATTACHED. . .. Spokane County-or fund agency SIGNED '
• . .'Indicated-above, that.l am autho TITLE
• . rized to authenticate and certify
. •
� •to said claim;.: .. DATE • � • .
• INTRA-GOVERNMENTAL VOUCHER
SELLERS
ACCOUNT
NT D+IST,1.RIBU..TION
• EXAMINED and ALLOWED
r ;i '•- t r' •• 5` ?ti ys SUa} ; il . " '4".. xaRpf� :+lirF6 " � --,
FUND AGENC AO- P " G:, •.;,%..:2,...1:413N-714ACTIvirY . -----, REV, JB NU BER � cTERECEi `
F • ,: ZT„ H ^GR3,!SOURCE'vr&RC r• '''''"'°•,''''''''0'.'-''''4''-'-''-'..' -.aA .5 v"ACCOUNT : a% CERTIFICATION DATE 19 9
• •
•
SIGNED CHAIRMAN
SELLER CERTIFICATION . ' •
Q�ICE ADMINISTRATOR
certify SIGNED MEMBER
I,herebythat the materials have been furnished,the services� • TIT
rendered or the labor performed as described herein or contracted TITLE 11/4/92
for,and that the claim is a just,due and unpaid obligation,and that DATE DATE MEMBER
I am authorized to authenticate and certify to said claim. •
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