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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 APPLE STATE ELECTRIC INC <br /> & <br /> 10011 3RD AVE SE#0 <br /> ADDRESS: EVERETT WA 98208 <br /> AMOUNT: $ 61.60 <br /> REASON: Request to cancel this permit, work not to be performed — refund at 80% <br /> GL CODE: B4 002-322-1200-831 <br /> INVOICE: E1904-157, 100113R"AVE <br /> SE,EVERETT WA <br /> (Please print this number on the refund check) <br /> Payment was received by the City of Everett on 04/18/2019 and recorded on E1904-157. <br /> May 14, 2019 .� k;/�v1 ( • <br /> (date) (Aut orized 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 />