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/ l <br /> CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer DATE:{ May 21, 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: $ 28.00 <br /> REASON: Request to cancel this permit, work not to be performed — refund at 80% <br /> GL CODE: BLDG 002-322-1101-831: <br /> MECH 002-322-1500-831:$28.00 INVOICE• M1902-051 <br /> PLMB 002-322-1300-831: (Please print this number on the refund check) <br /> SPRK 002-322-1800-831: <br /> ELEC 002-322-1200-831: <br /> Payment was received by the City of Everett on 02-21-2019 and recor ed on M1902-051. <br /> May 21, 2019 /;'r �a j <br /> (date) (Authorize. 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 />