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1986, 05-27 Permit: 00011237 Plumbing FixturesSIGNATURE OF OWNER ORAGENT. mnAnnRFnx III ADDRESS: PLUMBINC PERMIT APPLICATION DATE PLUMBINC TOTAL FEE FIXTURES: Bar Sink 0 Drinking ADO RE SS: O Floor Drain 0 Fee C/W Pipe 01 Laondry Tra WA 992 01 Ki-tche ri nk 01 LLUMB ING Water Close� 02 L ava�ory o� ur3. � na o Snower o/ PH! LIcENsEo: Bzdet 0 Other 0 ooR= Carbage Disposal 0 Sewer ? N Septic/HealTh # 0 IARCE�-: CENSUS TR: INSPECTOR: Fee PLAT N—E: o It USE OF PERIAIT: III ADDRESS: PLUMBINC PERMIT APPLICATION DATE PLUMBINC TOTAL FEE FIXTURES: Bar Sink 0 Drinking Foont O Floor Drain 0 Fee C/W Pipe 01 Laondry Tra Dish Washer E 01 Ki-tche ri nk 01 Sewer ec1 Water Close� 02 L ava�ory o� ur3. � na o Snower o/ Too 01 Bzdet 0 Other 0 Carbage Disposal 0 Sewer ? N Septic/HealTh # 0 Proces�ing Fee $5l.00 36.00 15.80 O9-77-0� ��7�� ��lOO� - ^~'''� '^""u OFFICE COPY