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CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer DATE: November 9, 2021 <br /> You are hereby authorized to refund the following: <br /> PAYEE JOHN GIACOMI <br /> & C.M. HEATING INC <br /> ADDRESS: 1415 BROADWAY <br /> EVERETT, WA 98201 <br /> AMOUNT: $ 60.00 <br /> REASON: CUSTOMER CANCELLED PERMIT E2110-182. <br /> GL CODE: BLDG 002-322-1101-831: <br /> PL CK FEE 002-345-8300-831: INVOICE: E2110-182 <br /> MECH 002-322-1500-831: (Please print this number on the refund check) <br /> PLMB 002-322-1300-831: <br /> ELEC 002-322-1200-831: $60.00 <br /> SEWER 401-343-50-109-460-00: <br /> SYST DEV STORM 401-379-50-123-460-14: <br /> PW REV 002-345-8312-831: <br /> PW INSP 002-342-4016-831: <br /> PAVING 002-322-4014-831: <br /> OVERPAYMENT REFUND 002-369-8101-000: <br /> FIRE DEPT 002-342-4000-014: <br /> Payments were submitted to City of Everett on 10/2/21 online via credit card. Refund at 80%. <br /> November 9, 2021 A I• *CA <br /> (date) uthorized Signature) <br /> Sabrina Good — Permit Services Manager <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 /> 1 ` <br />