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CITY of E DM ON DS SIDE S-EVER P E-'R M I
For Inspection Call 771-3202 ST"EET FILE PERMIT NO.
Address of Construction: 10TZ—Wh
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Property Legal Description (Include all easements):
Owner and/or Builder: AW =C,
Contractor & License No: 5PAD11(2ziWJ-A
Singl:e Family Residence V--*, �10Z 57�
Mul ti-Family (No. of Units ELYNN=VVOOD =LINE
Commercial
(No. of fixture Units
Invasion into City Right -of -Way: No L,," Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK RE C E i �- L-. j
-SEP 111989 9 1pq
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I ceftify' th6 I have read and shall comply PUBLIC WORKS D6te
with the items listed on the back.
Permit Fee -
Trunk Charge:
Assessment Fee
-W —
`2
Issued By: J -
;Date Issued:
Receipt No.:
Partial Inspection:
Comments
Final Inspection Approved: q-(,( A-
'--Ta Initial
Rejected:
eason
** PERMIT MUST BE POSTED ON JOBSITE **
Date Initial
--ffa t —e Initial
0)
Wh.ite Copy - File Green Copy - I.nspector Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO . .............. --------------- .............
(p, NEW CONSTRUCTION REPAIRS R LID NO . .................. ASMT. NO - ------------------
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OWNER------------------------------------------------------------------------------------------------ CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO.
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JOB ADDRESS --------------------------------- - ........
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PWW-0001 -11/75 (R EV. 11/78)
LEGAL DESCRIPTION: LOT NO - ------ . . ....... ................ BLOCK NO - -----------------------------------
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------------------------- - -------------------------------------------- 3 - -----------------------------------------------------------------------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
13A114-y- I
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t kA Approved:
DATE
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CITY OF EDMONDS
2/ /NE W
1:1 ADDITION
1:1 RETIREMENT
STREET HLE ASSET INFORMATION SHEET
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
DEPT. NO.
* * PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
*PROJECT NUMBER W 1 -1) �) I ()E-
PROJECT COMPLETION DATE
COST -,?
B.A.R.S. ACCOUNT NO. �j ( I Q 1 -1 �15 0 G 3
ESTIMATED LIFE 9�:: S
INITIATED BY
DATE
APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
Eq/D'EPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTR
REFERENCE DATE
� -6 4
7 RIFIED BY
PROCESSED
BATCH NO
ktnp INITI
DEPARTMENT FILE
NOTICE:
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-N0W`ar-ran,-*y.--o--
formation *shown on the attached
TheIn e by the City of
map(s) was compiled for us
Edmonds,; its Employees and Consultants.
The CitY ofEdm.onds does not. wa rra nt the
cy of anything set forth on these
accura
Map(�-). An . y person or entity -requesting a
copy,should conduct an independent
inquiry regarding the information shown on
th� -map(s),, IncludinS, but not limited to, -h
th . e location of any sewer stub shown, Suc
sewer stubs may or may not exist. and may
or may not exist at the location shown.
,�ity of Edmonds nor its
Neither the %_.. ice-rs be l.-Ja-b-IFe for the
empto,yee's o-r off"
information given' on this map(5), nor for
ntation provided based
any one represe
upon . said map(s),