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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 1117 <br /> COMPUTERIPERMIT # l51. ,�sJ,w/ _= <br /> SITUS/FACILITYjADDR/E/SS: /\ �'7�� W, vV'e� , <br /> DBA: Cafe /4/5 <br /> BILL TO: i efi —lNeS7- Tn_c PHONEI '915' <br /> �bf2Ib �{ SS <br /> BILLING ADDRESS: Z�� by <br /> CITY/STATE: Wa c/'"""n ,,-� <br /> PROGRAM: 0:57- TYPE OF SERVICE: <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COP4PUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME "�- <br /> of SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> 2.o OD 5hrs ' P��� 771! revt ' r�Q/I17I�//a <br /> 14� ' , RYNItu� �ubm�if.�[y tZlm� Uld <br /> 8Z9 9/ "o�o:oo Ir ,gin - Gr1rl vpr�Ev <br /> /El- qi /l)%Do Ip, eve semp�eres�Iw Qnvl <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DiVrE: <br /> EH 23 074 (Rev 3/22/91) / <br />