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1990, 06-28 Permit 90002927 Refund VoucherVENDOR CODE IS PERIAL DATA SUPPLY 1-W0-541-5926 SPOKANE COUNTY PAYMENT VOUCHER NUMBER 57717 NAME CHARLES RADER ADDRESS E. 11920 MANSFIELD AVE #026 SPOKANE, WA 99206 DATE 6/ 28/ 90 AGENCY BLDG&SAFETY NAME AUDITORS STAMP ACCOUNT DISTRIBUTION, ORIGINATING ENTITY (ALL VOUCHER TYPES) • 1099 REQ'D ID# LINE NO. VENDOR INVOICE NUMBER FUND AGENCY ORGAN- RATION ACT OBJ SUB OBJ REV SOURCE SUB REV JOB NUMBER KEPT CATEG, BS ACCT DESCRIPTION AMOUNT 1 BLDG&SAFETY 406 030 0008 2210 07 REFUND $35.00 DETAIL DESCRIPTION REFUND 100% OF PERMIT #90-2927, E. 11920 MANSFIELD I, the undersigned do hereby certify under penalty of perjury TOTAL $35.00 that sufficient funds have been AVE. GAS PIPING PERMIT NOT NEEDED. 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 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 am autho- rized to authenticate and certify TITLE INTRA-GOVERNMENTAL VOUCHER to said claim. DATE FUND AGENCY ORGAN- RATION SUB ORG SELLERS ACTIVITY ACCOUNT REVENUE SOURCE sue REV SRC -ACCOUNT DISTRIBUTION JOB NUMBER RPr CATEG. OFFSET - RECEIVABLES EXAMINED and ALLOWED CERTIFIC TION DATE 19 4 Wati{' CHAIRMAN SELLER CERTIFICATION I, hereby certify that the materials have been furnished, the services SIGNED rendered or the labor described herein f TITLE DIRECTOR MEMBER performed as or contracted for, and that the claim is a just, due and unpaid obligation, and that TITLE I am authorized to authenticate and certify to said claim. DATE DATE 6 / 2 8 / 9 0 MEMBER