21001 PIONEER WAY.PDF12824
21001 PIONEER
WAY
CITY OF EDMONDS
ASSET INFORMATION SHEET
N/NEW
1:1 ADDITION
El RETIREMENT
STREET FILE
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
D�VT NO
------------
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
I
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
k/DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE DATE
Wp) INITIAL
DEPARTMENT FILE
VERIFIED BY
PROCESSED
BATCH NO.-
.zd-
00
CD
cr_
CITY of E-DMONOS
For Inspection Call 771-3202
Address of Construction:
SIDE SEWER PERMIT
STREET FILE PERMIT, NO. 070.02
EDMONDS
PJ'0Pz<er (-A—TrOATMENT,
Property Legal Description (Include all easements):
Owner and/or Builder.: e-62 w 0 0 -:254 C ZO
Contractor & Li . cense No: Sal
Singl:e Family Residence
Multi -Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call all -Center (1�-800-424-555�) 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
I certify that/,Y have read and'shall comply Date
with t�e itemr listed on the back.
Permit Fee: 00 Issued By:
Trunk Charge: 00 Date Iss . ued: Rd
Ass'essment.Fee.: Receipt No. -
Partial Inspection:
'Comments la
Final Inspection Approved: J
Date Initial
Rejected:
Reason
PERMIT MUST BE POSTED ON JOB SITE
White Copy - File Green Copy Inspector
Date Initial
Date Initial
Buff Copy - Applicant
Side Sewer Drawing
The C!o*fs, %4; VAmotnAc
EASEMENT NO - ----------------- ---------------------
NEW CONSTRUCTION REPAIRS F-� LID NO - ------ ........ .--.ASMT. NO..--. --------------
OWNER SEPMOOD ----- VA9DkA.E_—_-o ...... 1w-
---------------------- CONTRACTOR C)_R_T).4.LA
_O&F ..... C_,O�t4jc ---- - - ---- ----
..RiE:m . PERMIT NO. rT-(O-C)2,-
JOB ADDRESS D-00-1 ------- ----------- LEGAL DESCRIPTION: LOT NO. .5 --------------- --------------- BLOCK NO - ---------- ED"DS ------
TREATMEN"G PLANI
-----------------_--- I ----------------------------- ------------------------------------------------------------------------ I ........................
NAMEOF ADDITION ----------- SEP% WWO a D -------------------------------------------------------------------
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Approved:
PWW-0001-1 1/75 (REVA 1/78) 00! ----- _-
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