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REFUND REQUEST
Date: 6/27/2011
Mailing Address: Kings Heating Inc.
6925 216"' St SW #C
Lvnnwood. WA 98036
Vendor #: 073579
Amount of Refund: $75.00
Receipt Number: REC053384
Originally Receipted in Account 200 — X -Permit Surcharge Fee $15.00 / 215 B -
Mechanical Permit fee $60.00 /
(Permit Trax Fee ID# & Description)
Refund to be Paid from Fund 001.000.000.257.620.000.00
Permit/App Number: BLD2011-0423
Reason for Refund: Void — Not in City
Requested by:
Approved by:
City of Edmonds czR Community Services