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4 <br /> CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer DATE: May 14, 2019 <br /> You are hereby authorized to refund the following: <br /> PAYEE C M HEATING INC <br /> & 1415 BROADWAY <br /> ADDRESS: EVERETT WA 98201 <br /> AMOUNT: $ 120.00 <br /> REASON: Request to cancel this permit, work not to be performed — refund at 80% <br /> GL CODE: B4 002-322-1200-831 $60.00 <br /> B2 002-322-1101-831 $60.00 INVOICE: E1903-003 &M1903-001, <br /> 519 PECKS DR—PETERSON <br /> (Please print this number on the refund check) <br /> Payment was received by the City of Everett on 03/01/2019 and recorded on E1903-003 & M1903-001. <br /> May 14, 2019 i // G <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 />