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20111025082455286.pdfREFUND REQUEST 114 .... . ...... . ................. - ......................... . ........ .......... .. . . .. ............................... Date: 10/24/11 Mailing Address,: Michell Construction '7907 212"' St SW #102 Edmonds,, WA 98026 Vendor : 070381 Amount of Refund: 6 Payment Receipt Number: Refund Receipt Number:_ Originally Receipted in Account Side Sewer Permit (Permit Trax Fee IID# & Description) I§ZMMp Number: eng2008O458 Requested by: --.,—,_Jennifer Lambert /_4..,,,,,,,_,,,..,,,,,..,,_ ­ ... .... . ..... ., ...... Lwu City of Edmonds c'Q Community Services IIIIIpIIIII OF f ...,. S 12l STIH�AVENUENOR.TH-EI�I�C7NDS,'wUl19�DMO- ���.��� - -%;�� Ff-►(1NE: (425) 771-0220 - FAX. (425) 771-0221. DATE: Monday, October 24, 2011 PERMIT : E-NG200 04.58 PROJECT ADDRESS: 547 DAYTON ST, EDI° O D PROP OWNER: 547 DAYTON ST EDM.ONDS, WA 9802.0.3431 Date Description Fee Amount Paid Bala ute Daae X -Permit Surcharge Fee $15.00 ($15.00) $000 lnspeclian Fees under Bl --20080287 ($50,00) $50,009 $0.00 11/20/2008 E-Sewe,rPermitFee $100.011 ($100.00) "$'0.00 10/2412011 E -No Work DanC-55 Permit (()TY: 1) ($50.00) $50.00 $0.00 10/24/2011 X -Na Worl< Done -Permit Sure g (QTY: '1) ($15.00) `615.00 $0.00 `fatal flue: 510.1111 $Q.00 $0.00 *TEL'S ARE ESTIMATED BASED ON INF'ORh ATION PRO VIOED,4T SUN,A JTTAS-S'UBdTC T T 0 CHANGE Il7��!ilt'S'1��1111iWlll Cl;1d�F`k�fll'Y [�]C�f►Y+ Date receipt # Method/Payee 7/14/2010 REC051469 Auto /f ichel Construction due E -Sewer Permit Fee X -Permit Surcharge Fee E -Engineering Inspection Fee Paid ($6.5.00) ($100.00) ($15.00) $50.00 1.0/24/2011 RECO54237 ' Refund / $65.00 F.,' -Sewer Permit Fee $50.00 X -Permit Surcharge Fee $15.00