1999, 03-30 Permit 99001328 RefundREFUND
PV MVG3269C) )18
Pv# NV0 269ssii18
Dept — BUILD L. FLAN
VENDOR:
LOON LAKE ENTERPRISES
PC BOX 99.;
LOON LAKE WA 9S14a
Vendor Conluclfl'oI
LGFS PAYMENT DOCUMENT
SPOKANE COUNTY AUDITOR
SHIP TO: BILL TO:
Confirming Ordor
Change Order ll
Bid ID
Blanketll
RC#
VI#
FOB:
ACCTG. PERIOD:
COMMENTS:
COMM I.NII
3/99
DESCRIPTION
COMMODITY NO
PO DATE: BLDG/ROOM:
DELIVERY DATE: WAREHOUSE:
ENTERED BY: L A UR 1 E CAR VJ_fk
REF ACCT LINE 1 QUANTITY
UNIT
BUYER
PURCHASING DIRECTOR: B E L A G. K U V A C S
UNIT PRICE
TOTAL PRICE
I D
PAGE TOTAL:
DISCOUNT TOTAL:
FREIGHT TOTAL:
SALES TAX TOTAL:
PURCHASE ORDER VALUE:
USE TAX TOTAL:
GRAND TOTAL:
28.80
28.80
0•00
0.00
0.00
28.80
0.00
26.80
LINE NO.
r1
FUND
lit.? 6
AGCY
ORG
03C O0C8
SB ORG
ACT
OBJ
SB OBJ
REV SRC
2210
SB REV
03
RPT CAT
BS ACCT
JOB NO.
PAY THIS AMOUNT
28. 8*'
TOTAL TO VENDOR: 28•3:;
P/F
RECEIVING CERTIFICATION
Materials ty1`:, ed in yuantit • ave been
received i1E� conditio or ontracted for.
DATE
PAYMENT CERTIF.
I, the and
materials h
a just, due an
nd certify to s
SIGNED
DATE
igned do
•e been furnish An
unpaid oblig
clai �e
A'1'ION
certify un er penalty of perjury that sufficient funds have been budgeted for this claim, the
rendered or labor performed as described herein or contracted for, that the claim is
against Spokane County or fund agency indicated above, that I am authorized to authenticate
ACCOUNTS PAYABLE
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.
SIUNED TITLE
DATE PAGE
1
. . . . .
riu Edit lArort Eroord. Eirgow 11,11,
' • —:frirE
Refunds
Typo of Refund •
BeceiPt 1 I Project AcctEolonce I
IT .
Eees to be Reliaidetl Rol und Amount I •
' .....
RelesdAsocve: •
,Refund Type
: F.... Voucher r: Crecit Cacti I '
. ;
AcOriginalm
Fee rost cRefund Refund
P
Invoke Refund Refund
Tm.. DOEA0.99.- Amount
Ila ME IMECHANICAL PMTS S35.00 S3S.00 . $36.00 80.0 $28.80
Total Ref undeck • 328.80
Doc ID: 99001328 Expiration Date:
Reasons 828 refund - L S 1 Inspected. Paid with
check 81740 Receipt 81354 on 3/2/99
6ccept
Cancel
0.1_12S11
-• ..... , V- .,-• • --•
Form via.
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PrrAtirs Lora ,:i:1;3,1. 7.7
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PYO/EkC/5" Noieet Numb.' 39001328 Do[-6LEONARD FLUNG $111s: 49482
APplir_orkt 1 lite
Inspections
r-
TnneastkotDot3D.
-11:71211
a`
Rept NO; 1533 j Data/Time YI4I sihrl User ID Ecoo 'Iran Typo: Ffehrnd
•, . .----.„ ,
Receipt fax ..,--
. Po/ Co.. Inv Mat Doc Tr. Amt Tipp_ Doe ID • Tender
99001320 2 MECHANICAL PMTS (S28.80) K Chockl 99001320 ($213.801
R000ld:
Total Projectu
(S28.801
Tran Ovor/IShortS 00.00
Net Transaction: (S28.80)
1 ..:_L01i, • et 1 (FlIteetd)
• Nat Tenders& • (S28.80)
....., .1
Change: $0.00- I,
Not Teedereck i02e.o0)
Reasore 008. refund - L I Inspected. Paid
with check 8.1
Total. 03 OC 0.00 -28.00
.2.11.3.14.1
•
farm Vivo,
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SPOKANE COUNTY DIVISION`OF'BUILDING AND PLANNING
1026 W. BROADWAY • SPOKANE, WA 99260-0050
(509) 456-3675
SITE INFORMATION
PROJECT INFORMATION
Site Address:
Parcel Number.
Subdivision:
Zoning:
Owner:
Address:
Inspector:
Water Dist:
18605 E COURTLAND AVE
SPOKANE, WA 99216
55064.0206
DONWOOD EAST
UR 7
ALBERT, HOWARD
18605 E COURTLAND AVE
SPOKANE, WA 99216
LEONARD FLUNO
Project Number: 99001328 Inv:
ennit Use: GAS RANGE & PIPING
1 Issue Date:
Applicant: LOON LAKE ENTERPRISES
Phone: (509) 233-3002
Address: PO BOX 990
LOON LAKE, WA 99148
Contact: JDAVIS/LOON LAKE EN Phone: (509)233-3002
PO BOX 990
LOON LAKE WA 9
Setbacks - Front Left
Right: Rear:
3/2/99
C
PERMIT(s)
Mechanical Permit
Tran Date
3/2/99
cz-
Contractor:
LOON LAKE ENTERPRISES License #:
LOONLE*066DB
GAS PIPING
PROCESSING FEE
r �S J�JPC%TAT/'
PAYMENT SUMJ IARY
By: SHATTO, JULIE
Receipt # Payment Amt
1354 536.00
Total Fees AmountPaid AmountOwina
536.00 $36.00 $0.00
Page 1 of 1
1 $1.00 RANGE
$25.00
NOTES
$10.00
Total Permit Fee: $36.00
11,4.,44444.444 .4944:414, . , ,,„
Oar
44$436/13-4 „
Waystota6,
Aft c.d., CU_ NOS
410001141,1444014,4 Waffialt ' " Tegst
Total Ralundett 128 80
Doc le: 99001324 xpeation Datcc
FIcamec 004refundt L & I Inspected. Fed we
check 111740 Receipt 41354 on 3/2/99
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Net gamaction:
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with check 8.1
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