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12902 19TH AVE SE GENUINE SMILE DENTISTRY 2021-02-23
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12902 19TH AVE SE GENUINE SMILE DENTISTRY 2021-02-23
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Last modified
2/23/2021 1:57:50 PM
Creation date
2/23/2021 1:43:36 PM
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Address Document
Street Name
19TH AVE SE
Street Number
12902
Tenant Name
GENUINE SMILE DENTISTRY
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CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer . DATE: Alil 15, 2020 <br /> You are hereby authorized to refund the following: <br /> PAYEE FROULA ALARM SYSTEM <br /> & 861 INDUSTRY DR. <br /> ADDRESS: TUKWILLA, WA 98188 <br /> ` . <br /> AMOUNT: $ 50.00 <br /> REASON: Duplicate permit issued. E1910-125 iss 1/ /2019. E2001-097 applied for again by same <br /> contractor and issued by permit staff 1/29/ 0 •. The work was inspected and finaled under <br /> #2001-097. Refunding duplicate permit El• 0-125. <br /> GL CODE: 002-322-1101-831: <br /> 002-322-1500-831: INVOICE #E1910-125 <br /> 002-322-1300-831: (Please print this number on the refund check) <br /> 002-322-1200-831: $50.00 <br /> 002-322-4011-831: <br /> 401-343-50-109-460-00.' <br /> 401-343-40-119-471-0 <br /> 002-345-8300-831: <br /> 002-345-8112-10 <br /> 002-369-8101-0 0 0: <br /> 157-345-8601 1 00: <br /> Payment was received by th; City of Everett on 11/17/2019 and recorded on E1910-125. <br /> April 15, 2020 <br /> (date) (Authorized gn- ure) <br /> Tony Lee— Building Official <br /> (Title) <br /> Refund by Check No. Date <br /> Original Receipt Attached <br /> Account Debited: <br /> Or refund noted on Treasurer's Office Copy. <br /> ( r/? <br /> Prepared by TJ <br />
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