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2000, 01-11 Permit 00000200 Range RefundTITLE Pv# Dept REFUND iVG'N 00 030 — CODE LNFORCt_ VENDOR LLL O_W CONSTRUCTION P. 0. BJX 14406 SPOKANE, Vendor Contact/Tel WA 99214 EPS PAYMENT DOCUMENT SPOKANE COUNTY AUDITOR SHIP TO: SILL TO: Confirming Order Change Orate # Bid ID Blanla t# RC# VI# FOB: ACCTG. PERIOD: COMMENTS. COMM LN# 7 06/99 DESCRIPTION PO DATE: DELIVERY DATE: ENTERED BY: BLDG/ROOM: WAREHOUSE: COMMODITY NO 1 REF ACCT LINE I QUANTITY I UNIT 95002429— 103 ,. FrT N ' PROJECT CANCELLED-80% REFUND $4.50 X 100% = 95002429-5105 S. FELTS LN $180.54 X 80% _ TOTAL REFUND $ 4/50 +144.43 $148.93 SYSTEM 1/0ID BUYER PURCHASING DIRECTQR: UNIT PRICE PAGE TOTAL: DISCOUNT TOTAL: FREIGHT TOTAL: SALES TAX TOTAL: PURCHASE ORDER VALUE: USE TAX TOTAL: GRAND TOTAL: TOTAL PRICE 144. =:3 148.93 0.00 0.00 0.00 148.93 0.00 DINE NO. FUND AGCY ORO SB ORG I ACT OBI SB OBI REV SRC SB REV RPT CAT BS ACCT JOB NO. LAY THIS AMOUNT 144.4J 3706 4.50 TOTAL TO VENDOR: 148.93 P/F RECEIVING CERTIFICATION Materials noted in quantity ✓ have been received in good oondi¢on or contracted for. � SIGNED t``1r6f/ \f ACCT 'TECH 3 PAYMENT CERTIFICATION 1, the undersigned do hereby certify under penalty of perjury that sufficient funds have been budgeted for this claim, the materials have been furnished, services 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 authorized to authenticate and certify to said claim. S►GN(ED 4/04 7/2f JJ 24. TITLE DIRECTOR 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 account thereof. SIGNED TITLE DATE 6/21 /95i DATE; 6/21/95 DEPARTMENT2 DATE PAGE • SPOKANE COUNTY DEPARTMENT OF BUILDINGS WEST 1026 BROADWAY • SPOKANE, WA 99260-0050 (509) 456-3675 SITE INFORMATION PROJECT INFORMATION ) SITE ADDRESS: 5105 S FELTS LN SPOKANE WA 99206 PARCEL NUMBER: 44053.9148 IUBDIVISIOM: SP-740-92 LOT: 2 BLOCK: ZONE: SR-1 INSPECTOR: DAVE SILVA WATER DIST: OWNER: VELIS, GEORGE PHONE: 509 926 8118 ADDRESS: 5105 S FELTS LN SPOKANE WA 99206 PROJECT NUMBER: 95002429 ISSUE DATE: 04/18/95 PERMIT USE: 20 X 30 DETACHED SOTRAGE APPLICANT: ELLIOTT CONSTRUCTION PHONE: 509 928 6415 ADDRESS: PO BOX 14406 SPOKANE WA 99214 BUILDING CONTACT: LANCE ELLIOTT PHONE: 509 928 6415 SETBACKS -> FRONT: 50+ LEFT: 80 RIGHT: 50+ REAR: 35 LENDER NAME: PHONE: ADDRESS: TaePERN IT - CONTRACTOR ELLIOTT CONSTRUCTION COMPANY LICENSE S: ELLIOCC153R9 MEW BUILDING DIM.. 20 X 30 1 STORIES SS FT . 1160 STORAGE M-1 VW 1160 TOTAL VALUE: RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE 153.00 4.50 27.54 TOTAL ►ERMIT FEE S185.04 PERMIT(S) 4-1- ,/ E -(i/P/ INSPECTION REQUESTS TO MAKE SURE YOU GET AN INSPECTION WHEN YOU NEED IT CALL OUR OFFICE AT 456-3675 24 HOURS IN V JOB ADDRESS: i 0.5 �C' INSPECTOR: vt�G.'i'-G- 4'1F1 j1 YOUR PERMIT NUMBER IS: (fS -_. L'j' 1 - DON'T FORGET...YOU CAN CALL IN YOUR REQUEST 24 HOURS A DAY - 7 DAYS A WEEK Spokane County Department of Buildings • Wesl 1026 Broadway Ave Spokane WA 99260 PAYMENT SUMMARY ) PAYMENT DATE RECEIPT* 04/18/95 00003109 TOTAL FEES AMOUNT PAID S185.04 S185.04 PAYMENT AMOUNT S185.04 AMOUNT OWING S.00 SITE : LOWEST OPENING, INCLUDING BASEMENT OPENING OR TOP OF WINDOW WELLS, MUST BE HIGH ENOUGH TO ALLOW A MINIMUM SLOPE OF 2% AWAY FROM BUILDING. ALL DRAINAGE SHALL BE ROUTED AWAY FROM THE BUILDING TO NATURAL DRAINAGE OR OTHER LAWFUL DRAINAGE FEATURES. THIS ALSO APPLIES TO S. 5105 FELTS LANE, PROJECT NO.92010780, AS S. LIGHTFOOT, COUNTY ENGINEERS. IBSLIED PERMIT BY: CAROL FRAZIER