2007, 01-31 Receipt FAS Alteration Permit-LNIPage 1 of]
Receipt
Washington State Department of Labor and Industries
Customer: ZAN BREZA
Address: 8607 E VALLEY WAY
City: SPOKANE State: WA Zip: 99212
-- Fiscal Transaction Receipt --
Fiscal Transaction: 101553462
Created: 1/31/2007
Payments: $74.30
-- Payments --
Type Amount Payer Reference
Check $74.30 ZAN BREZA 7233
-- Services --
FP1375056
Description
Structural* - OTHER STRUCTURA
Reference
FP 1375056
Quantity Price
1 $74.30
FP137505.6
Id; 10155742
NOTE: All refund requests must be made in writing. Refunds may require processing
through central office and we cannot guarantee immediate refunding of services.
http://field-services.apps-inside.lni.wa.gov/FrontCounter/FCRevRecWeb/PConfirmPage.Aspx?AppID=2... 1/31/2007
THESE PLANS MUSTK KEPT
ON THE JOB SITE
.000 %My
REVIEWED FOR CODE COMPLIANCE
SPOKANE vAir: SUILDING DIVISION
Edit Confirmation
Page 1 of 2
PAIRS Version 1.1.50.0
Logged into Production as HALPAIN, KAY
Confirmation
Permit FP1375056 Manufactured/Mobile Home
oS: CRS L...CIT 1 CM ._....'SRC
Purchaser
Contractor ID
Company Name
Last Name
First
Address
City
Phone
Site
Information
Site Owner
Last Name
iULU
BREZA
ZAN
j
8607 E VALLEY WAY
SPOKANE
(509)891-2680
VOID
Print Request
Status ctive
Applied [1/31/2007 j
Expiration [1/31/2008 j
State[WA Zip99212
BREZA
First VAN
Address 422 S PARK RD
City [Spokane j State
Not In The City
Location [SPOKANE
Phone1(509)891-2680
Description
Notes
Directions
Power Company
REPLACE OLD DOOR WITH NEW ONE
# Reqs
# Insps
Created fha1y235
L31/2007
:38 AM
Updated lha1y235
11 /31 /2007
EAST ON 5TH TO PARK GO NORTH TO #422
Services
Description
Quantity
Structural" - OTHER STRUCTURAL CHANGES
Total Cost
Total Paid
Total Due
Amount
$74.30
$74.30
$74.30
$o.00
Edit Permil
http://scsd.apps-inside.lni.wa.gov/pairspermit/frmEditConf rmation.aspx?SmsgId=541557&SmsgSender= .. 1/31/200';
Page 1 of 2
POST ON JOBSITE PRIOR TO BEGINNING OF WORK
Contractor Name License Number
Purchaser's mailing address
8607 E VALLEY WAY
SPOKANE WA99212
Telephone number FAX Number
(509) 891-2680 () -
Premises owner's name
BREZA, ZAN
Address of inspection
422 S PARK RD
Spokane
FAS ALTERATION PERMIT #FP1375056
Installation Description:
REPLACE OLD DOOR WITH NEW ONE
Services to inspect:
Description
Structural* - OTHER
STRUCTURAL CHANGES l
Inspection fee: $74.30
This permit expires in one (1) year from date of last activity.
Applied: 1/31/2007 Expiration: 1/31/2008
Quantity Amount
1
$74.30
Date Approved By Date Approved By
MECHANICAL PLUMBING
Type Type
ELECTRICAL STRUCTURAL
Type Type
OTHER OTHER
Type Type
Inspection Date Area, Building or Equipment Inspected Action Taken Inspector
Property Owner: This is your permanent record of inspection
http://scsd.apps-inside.lni.wa.gov/pairspernut/rptFASPermit.aspx?AppID=102 1/31/2007