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CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer DATE: June 19, 2017 <br /> You are hereby authorized to refund the following: <br /> PAYEE Matthews David & Erin <br /> & 4816 College Ave <br /> ADDRESS: Everett WA 98203 <br /> AMOUNT: $ 80.00 <br /> REASON: 80% REFUND — OWNER AND CONTRACTOR PULLED ELECTRICAL PERMITS, <br /> REFUNDING OWNER Litg16 f <br /> GL CODE: B 002-322-1101-831: `itg 1(0 ,�1 � C ti. <br /> M 002-322-1500-831: INVOICE• E1705-106 <br /> P 002-322-1300-831: (Please print this number on the refund check) <br /> E 002-322-1200-831: $ 80.00 <br /> 401-343-50-109-460-00: <br /> 401-343-40-119-471-02: <br /> 002-345-8300-831: <br /> 002-345-8112-102 <br /> 002-369-8101-000: <br /> 002-2374-3401-000: <br /> 157-345-8601-000: <br /> Payment was received by the City of Everett on 05/17/17 and rec rded on E1705-106. <br /> June 19, 2017 <br /> (date) (Authorized Signature) <br /> Paul McKee-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 /> ft/Le <br />