1993, 06-08 Permit 92011145 RefundK t; r U N ; EPS PAYMENT DOCUMENT
PV# MVD 6 7 M J W O 1 SPOKANE COUN'T'Y AUDITOR ct>ww Omer #
Dept 03 — CO.0: ENFORC
Bea m
VBNDOR
SHIP M. BILaL TO: Blanket#
NORCO HEA T IN6 & A/C t INC.
3103 EAST TREINT AVENUE:
SPOKANEt WA J9212
VI#
Vendor Contact/Tel Cordhudw Order
FOB -.PO DATE: BLDG/ROOM: BUYER
ACCTG. PERIOD: / 9,:1 DELIVERY DATE:J WAREHOUSE: DONALD L• L A B R E C Q U E
Di[Rr`[-[11C[Tll` fIIREC'TC�R•
'r'� 21 Q > d ` 4608 E 4TH AVE -PROJECT CANCELED 3
C/o X 49.00 = $39.20 C• O C C C �� C . c J
'V' 1;1114 19325 E DOVE CIRCLE -PROJECT CANCELED D 0 0 0 006 3 y. 2
80•1c X 49.00 = 39.20
TOTAL REFUND $78.40
PAGE- TOTAL: 7.3.4`1
GRAND TOTAL_: 7�94C
O. R W3 UNU jit- I UD DD UD to
tIi 406 .17 11
406 n_33 "L06a 210 „7
EI ERTIF ATION PAYMENT CERTIFICATION
rials:noted i nand V have been Xnby
y certify under penalty of perjury that sufficient funds have been budgeted for this claim, the
a' in good n or contracted for. Lerial, services tendered or labor performed as desaibed herein or contracted for, that the claim is
d'on against Spotane County or fund agency indicated above, that 1 am authorized to authenticate
SIGNED d ce TITLE SIGNED"TTT'TE
ZZ
DATE ��� DATd/—)
Ar^r`rli IIJTC PAYARI P
GRAND TOTAL:
TRAVEL CERTIFICATION
1 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 accountthereot
SIGNED TITLE
,....� PAGE
PRO.)ECT 9?01 1145
'—' ------------� � DATE 12/23/97
T%%UED P�RMIT =
������
PERMIT WORMATION *****»********************x«
%I7E STREET= 19325 E DOVE CIR PARCEL*= 9503.2302
ADDRESS= GREENACRE% WA 9906
PERMIT USE= GAS WATER HEATER, HEATING EQUIPMENT, & PTPJNG
PLATO= 000000 PLAT NAME= UNKNOWN = RMH
n»�nDI%TO= G
'
B = /- ZDEPTH R/U=
= F/A= F WIDTH:::: DEPTH=
0 OF B= i 0 DWELLINGS= 1 WATER DIST =
OWNER= LAIRD, DEL. PHONE= 509 927 7H57
%'--- T= 19325 E DOVE CIR
ADDRESS= GREENACRE% WA 99016
�975
CONTACT NAME= NORCO HEATING PHONE NUMBER= 509 534
BUlLDIAG SETBACKS: FRONT= N/A LEFT= N/A RIGHT= N/A REAR= N/A
**************************«**** MECHANICAL PERMIT **************«**««**x****
' CONTRACTOR= NORCU HEATING & AIR CUND INC PH0NF= 509 534 49745
NTRT-4-T--5iO3 E TRENT AVE _
ADDRES9= SPOKANE WA 992i2
QUANTITY FEE AMOUNTITEM DESCRIPTION
-------------�� 2� 8O
PROCESSING EE Y ^
WATERGAS HEATER
QPiiO0,0OO>BTU
*na n'"GAS I�;"' 2 ?.0O
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT# PAYMENT AMOUNT
12/23/92 1460 . 49,O0
TOTAL DUE= .00 TOTAL PAID= 49.08
PERMIT TYPE
__ __FEE _AMOUNT _ _AMOUNT _PATO _AMDUNT_OWJNG
---------------- 49.0''..') OO \
MECHANICAL PRMT 49�O0 ------- __
49.00 49.00 .00
PROCESJED BY: DOMITROVICH, ROBIN
PRINTED BY: DOMITROVICH, ROBIN
******************************** lHANK YOU ************************»****
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