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5103 S 4TH AVE 2024-02-16
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5103 S 4TH AVE 2024-02-16
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Last modified
2/16/2024 11:36:37 AM
Creation date
2/16/2024 11:35:33 AM
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Address Document
Street Name
S 4TH AVE
Street Number
5103
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CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer DATE: August 26, 2021 <br /> You are hereby authorized to refund the following: <br /> PAYEE BARBARA MCLEAN <br /> & 5103 S 5TH AVE, #1A <br /> ADDRESS: EVERETT, WA 98203 <br /> AMOUNT: $ 128.00 <br /> REASON: CUSTOMER PROVIDED WRONG FIXTURE COUNT ON PLUMBING APPLICATION. <br /> GL CODE: BLDG 002-322-1101-831: <br /> PL CK FEE 002-345-8300-831: INVOICE: P2108-007 <br /> MECH 002-322-1500-831: a��>rr'T�-t�NrT,`T17'i� Rv <br /> PLMB 002-322-1300-831: $128.00 eminucettrit r(27(mtet( wortiy4 <br /> ELEC 002-322-1200-831: (Please print this number on the refund check) <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 /> Payment was submitted to City of Everett on 8/16/2021 and recorded on permit P2108-007. Refund 80% of <br /> $160.00 fixture fees. <br /> '- CAugust 26, 2021 � Lj - J <br /> 6Te)w <br /> (date) (Authorize ature)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 /> I � <br />
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