11745 SW PACIFIC HIGHWAY-2 11745 sw PACIFIC HIGHWAY
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Permit No.
Addresse�-
Marne cl Occupant------- Permit claarge.---
Paid by
Date connected
Type of Building Inspection fee
Service Bate Paid by -ite
Contractor Asiessment—l�L, 'f L�_—Pa,-d---
Site of connection