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11731 AIRPORT RD LA PALMERA RESTAURANT 2019-10-30
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11731 AIRPORT RD LA PALMERA RESTAURANT 2019-10-30
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Last modified
10/30/2019 2:57:09 PM
Creation date
10/30/2019 2:55:43 PM
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Address Document
Street Name
AIRPORT RD
Street Number
11731
Tenant Name
LA PALMERA RESTAURANT
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6/11/2019 Snohomish Health District l D 61° <br /> Snohomish Health District SNOHOMISH <br /> ISH <br /> HEALTH DISTRICT <br /> 3020 Rucker Avenue,Suite 104 ilitz9 <br /> W W W.SNOHD.ORG <br /> Everett,WA 98201 <br /> Phone:(425)339-5250 <br /> ENVIRONMENTAL HEALTH SERVICES RECEIPT Receipt No:#000008479 <br /> Date:Jun 11,2019 <br /> Invoiced To Billing Information <br /> ► Hector M Mendoza ► X00X-XXXX-XXXX-8318 VISA <br /> ► 1717 s lake Sticklney dr ► Hector Mendoza <br /> ► LYNNWOOD,WA 98204 ► 1717 S Lake Stickney Dr <br /> ► Phone:(102)750-1827 ► Lynnwood,WA 98087 <br /> ► Phone:(425)750-1827 <br /> ► lapeverett@hotmail.com <br /> Invoice Description Total Paid <br /> PLAN REVISION ALTERATION TO EXISTING $185.00 <br /> PAYMENT(CREDIT) -$185.00 <br /> IN0 43433 GENERAL FOOD PLAN REVIEW $500.00 $315.00 <br /> PAYMENT TRANSFER(DEBIT) $185.00 <br /> PAYMENT TRANSFER(CREDIT) -$185.00 <br /> CHARGE REVERSAL -$185.00 <br /> Total amount paid: $315.00 <br /> https:/lsnohomishonline.envisionconnect.com/#/paymentService/paymentReceipt/bd2be9b4-9683-4669-a2de-aa690132ae81 1/1 <br />
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