1988, 10-18 Permit: 88003287 Addition SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
nd correct.In
I certify o that I e read and understand the INSPECTION tREOUIREMENTS/NOTICE provisions ihe information contained in it and ncluded herein and ed by me or my agreeent oto comply with samempile said .All provisions is true of laws
addition,I have
cupanc shall n• • strued to give authority to violate or cancel the provisions of any state or local law regulating
and ordinances governing this type of work will be complied with whether specified herein or not.I understand that the issuance of this permit and any subsequent
inspectioconstruct n,approvals oCtcfp • Y
construction,or as a warranty otp6nfor ance with the •rovisio• of any state or local laws regulating construction. i✓ -
APPLICATION r, dip .i. ,
SIGN URE OF :'
R AGENT #4 ATE
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•j,.:,(m ai..)i..)i.:k•)(••),i ni)(**:,(.***1n::N;ir;'i 1(.iii iii..;(•;(• PERMIT INFORMATION .)(••i,i: . *.;i••)(****)t'1(••R.:,(.)ii•i(•')t**•)('•)(•li'';('*'h''1':')'
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SITE STREET= I ? ti r
24TH AVE
42-9054
I::(art?:1 r,L.. it
i
PERMIT USE= ADDITION TO MOBILE HOME
... :. NAME= I .4NGl „ ..
B L..l.?C'i::::: L..I::I..i.:::: DEPTH= 1.. 1.
00000065 . I) WIDTH=
:1: OF Ill...:?o :::: 4 DWELLINGS=
10
' OWNER= RENZ , ALFONS 0 PHONE=iOi.I... ' 5 .. . 8 5084
r7 ;
... RESS._ VERADALE WA 99037
PHONE NUMBER= 509 924 6530
•
CONTACT Ni'•tr'tE:::::: OWNERN� RIGHT= REAR=- NAT .... ?
BUILDING SETBACKS : I•' I•'..t.l I . . .
j,;•i,i)+i 1(:1;,.ji.:,;..p..j;!.j,..j,,.p;:,i.)k.)i..p;•)(;i)k Iii H 1()'i'Ji 'ji'')'
.y,.:pi•)i:.Jr..ji:•)(••;(•)t}.yi..;i.),:•)r•)t•n:.,i..,,,.,,,.Jq.,,..)t..,,:n•li•�),:•n:•Ui•)i:1r..j;,.p;�i• BUILDING F'L:.I°:I"�..
PHONE=1-.i:�i`l? RACI D C:::: OWNER
•
DDITION= X I i
F USE=
NEW= REMODEL= I J ( ... i .... STORIES= 1 •
c:It::l:I..JF' :. I...D:::: BLDG HG
T=
tAI t ti .::: 8 X 24*HANDICAP= SEWER= N HYDRANT=
REQ PARKING=
I i.', 1:-..1. VALUATION
l; :t)L., (::F::I:I'..(.:I:t:?i'! (:;F:i.:?l.JI' (`t I'F::
F' r...>60 t t
I' ITEM DESCRIPTION QUANTITY F 1:::E AMOUNT
( RESIDENTIAL V4I...l.JATIONY 81 .000
,'TAE.: UF�;i:.II6,RGE:
( iYJjPi (Pi : ! t 9 P4t 3 . : * i*; ) ) a * PAYMENT
SUMMARY
) i ( , ;: ; ; ) ( () C; ) ie; ; ;; ) i ) : i ( i
PAYMENT DATE RECEIPT*
PAYMENT AMOUNT
i
:
10/18/80
j: i' 8 /80 42iI 84 .50
..
TOTAL DUE= . .. ..
TOTAL PAID= 04 .50r
.. FEE L:.
I::'I. I�:t'i.I: i I `r F�'I: 1::. Ai'iC?1.JN..I' AMOUNT PAID AMOUNT OWING
B1..1.J.i....1)T.i I l..x I' I::.I'.,1.l. I 34 .50 ............................................... .............................................._.._
04 ,50 84 ,50 .00
PROCESSED BY : I I::?F:F:'''r , JEFF
i PRINTED BY : WENDEL , GLORIAI
l: c! i •;: ):•) )i; ) ): ! .3 j •(: ;} Pi*) Ii ; ( () THANK YOU ******** ***************Y:****) ) . ., , . , *, (j ) ; i .Jii ( ip ): :Nt
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VENDOR
CODE
Superior Business Forms
SPOKANE COUNTY PAYMENT VOUCHER
NAME
ADDRESS
DATE 11/1/88
AGEN%tLDG&SAFETY
NAME
SOUTH 2205 CARNINE COURT
VERADALE, WASHINGTON
AUDITORS STAMP
ACCOUNT DISTRIBUTION, ORIGINATING ENTITY (ALL VOUCHER TYPES)
YENDoii"
INVOICE NUM
88-3287
AOENCY ORGAN
E IZATION
ACT
OBJ SOUR
MBER
TEo
BS
ACCT
MOUNT,`
010
030
0008
2210
02
refund
$64.80
88-3287
020
675
3700
refund
$ 3.50
Refunding 80% of permit #88-3287 issued for an
addition to a kamisx manufactured home - the material
for the addition (E.15907 24th Avaeue) are to be
the same as that for a mobile home. It is the
jurisdiction of the State L&I Department.
80% of $81.00 = $64.80
100% of $3.50 = $ 3.50
NZATION
INTRA -GOVERNMENTAL VOUCHER
SELLERS ACCOUNT DISTRIBUTION ,
oRG' "TM -REVENUEAOURCE
REv JOB NUMBER CAtf.,.
S
SELLER CERTIFICATION
I, hereby certify that the materials have been furnished, the services
rendered or the labor performed as described herein or contracted
for, and that the claim is a just, due and unpaid obligation, and that
I am authorized to authenticate and certify to said claim.
SIGNED
TITLE
DATE
AUDITOR
I, the undersigned do hereby
certify under penalty of perjury
that sufficient funds have been
budgeted for this claim, the ma-
terials have been furnished, ser-
vices rendered or labor performed
as described herein or contracted
for, that the claim is a just, due
and unpaid obligation against
Spokane County or fund agency
indicated above, that I am autho-
rized to authenticate and certify
to said claim.
� E-• IF CAI°IQN
�
SIGNED 0voisot\„.
TITLE OFFICE MA AGER
DATE 11/1/88
TRAVEL CERTIFICATION
I hereby certify under penalty of perjury
that this is a true and correct claim for
necessary expenses incurred by me and
that no payment has been received by me
on account thereof.
SIGNED
TITLE
DATE
EXAMINED and ALLOWED
DATE
19
CHAIRMAN
MEMBER
MEMBER