21114 80TH AVE W.PDF111111111111
7174
21114 80TH AVE W
C I T Y o f EDMONDS
S I D E S E W E R P E-R�,,,!T,�A
For Inspection Call 771-3202 PERMIT No. 07909
STREET FIL
Address of Construction:
Property Legal Description (Include all easements):
4E,F— kZ=bCm PM 64-S-
I
Owner and/or Builder:
Contractor &-License No: /PA c / -Z !I ze5
VIA BALLINGER
Singl:e Family Resi�dence LIFT STATION,
Multi -Family V-,-' ANo. of Units _3'
Commercial (No. of fixture Uni'ts
Invasion into City Right -of -Way: 'No 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 —RE -AD THE ITEMS LISTED ON THE BACK
RIEC E
0 5 1988
tert ify that I have read and shall comply Date.
/with the items 'listed on the back. PUBLIC woke,,.
Permit Fee:
Trunk Charge:,
Assessment Fee:
Issued By:. __4
1kate Issued: 49
Receipt No.: ?,4 .0 A
Partial Inspection:
Comments Date Initial
Final Inspection' Approved:
-;r
00
Rejected:
CD
White Copy File
Date - Initial
son
** PERMIT MUST BE POSTED ON JOB SITE **
Green Copy -'Inspector
Date Initial
Buff Copy - Applicant
#P20
CA File No:
Critical Areas Checklist
Site Information (soils/ topography/hydrology/v tation)
V/A
1.. Site Address/ Location: z///ZP S-04- �W7 -7
2. Property TwAccount-Number:
3. Approxninate Site Size (acres oi square feet): X
4. Is this site currently developed? -**yes; no.
If yes; how is. site developed? 67o lcloo o
5. Describe the general site topography. Check all that apply.
Flat less than 5-feet elevation"change over entire site.
Rolling: slopes on site generally, less. than 15% (a vertical rise of 10-fe
et -over. -a horizontal
distance of 66-feet).
Hilly: Slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet
over. a horizontal distance of 33 to 66-feet)-
Steep: grades of. greater than 30% present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please desaibe):
6. Site contains areas of year-round standing water: A10 Approx.,Depth:
7. Site contains areas of seasonal standing water: A40 Approx. Depth-.'
What season(s) of, the year?
8. Site is in the floodway A/6 floodplain _A/� of aw.ater course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? Mv (What time of year?
10. Site is primarily: forested A/c, Meadow —A& ;shrubs mixed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site: Alo
4"01
—For G!y Staff Use Only -i�� e-
1. Plan Check Number, if ap
p
2. Site is Zohed? 'SM-Q,q
3. SCS mapped soil type(s)?
C, pg&�
4. Critical Areas inventory or C.A. map indicates Critical Area on site?—A/0.
5. Site within designated earth subsidence landslide.hazard area? tin
DETERMINATION
STUDY REQUIRED WAIVER
Reviewed Date: /na
#P20
lb- 1 Qq%)
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by -any person preparing a Development
Permit Application4or the City of Edmonds priorto
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed - to complete the Checklist should be easily
available fromobservations of the site or data available at
City Hill (Critical areas inventories, maps, 'or soil
surveys).
/ — a I <' 0 & 1W �; ftJo I i 17,
Date Received:
City Receipt#:
Critical Areas File M
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized representative,
must fill out the checklist. sign and date it, and submit it
to the City. The City will review the checklist,,make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, . the applicant shall -include other pertinent
information .(e.g. site, plan, topography map, etc.) or
studies in conjunction With this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, 'in consideration on the processing of the application agrees
to release, inderrinify, defend and hold the City.of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction. based in whole or part upon false, misleading, inaccurate or
incomplete information fumis6d by the applicant, histher/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE oF APPLicANT/AGENT
DATE
Property O*vner's Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER
PLEASE PRINT CLEARLY
Owner/AppHcant:
1_4e A-t 6_�� 7�6_,4 0 ,,,eEE Z-0 1*716 AJ 0 C
Name
Street Address
Co "OVO5 Wtq
90"'Al 4
city State . Zip
Telephone: 6-14.0—) -,� -2 5" — a,.� 0//,
Email address (optional):
DATE
Applicant Representative:
// 47;0 - t/_ �20 R C- / -1 -9
Name -
-7 T7-
Street Address
-6
city State Zip
Telephone:
Email Address (optional):
The City of Edmonds Side Sewer Drawing EASEMENT NO - ----------------------------------------
NEW CONSTRUCTION ?( REPAIRS n LID NO - ----------- ------ ASMT. NO - ------------------
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR --------------------------- PERMIT NO.Q7.1-lb-i
JOB ADDRESS - ------ ------ A,3--E --------- V,
L ............. LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
Lk
,�, I I t (f FS 0'r " AQ 6-
PWW-0001-11/75 (REV.11/78)
A t
NAMEOF ADDITION ------------------------------------------------------------ ----------------------------------------------------------
C�u 0-4nc> —vD OF QtZtko�- VIA =E83ALLINGER
LIFT STATION
L�e C1,0 4+' D P- ezp
I-- I I
Approved: )k .
DATE L 0..:l7nc.FE .................. By&;;
to(
NOTICE:
No warranty of accuracy.
The -information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edmonds does not warrant the
accuracy of anything set forth o.n these
map(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
-fh-e -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may'not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emp-l-o-yees o-r offiCers sh-dall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
STREET f1LE._,.!.
r
N"E
713DRESS
PLIlem MOW OF WAY PtR OFFOMAL 8MLrT
EX9STING_—
REOVIREDIDEDICATiON
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED AoO
STREET USE PERMIT REQUIRED �-.
SEE ENGINEERING MEMO DATED'
CITY TELEPHONE NUMBER REMARKS
NAME
_��YIVX_V
cc ADDRESS
0 t
77 4 --]FIXTURE UNITS
METER SIZE ILDING SUPPLY SIZE
cc CITY TELEPHONE NUMBER
I- — ru
z
0 REMARKS
STATE LICENSE NUMBER
I SIGN AREA ENV. REVIEW ADB NO.
Legal Description of Property - include all easements ALLOWED PROPOSED COMPLETE EXEMPT
(show below or attach four cop�les) SHORELINE#
2z_
CL
z VARIANCE OR CU PLANNING REVIEW BY
DATE
Aj
0
_j YARDS
HEIGHT LOT COVERAGE
'(Dw 1101�-611
W
_j FRONT SIDE REAR
REMARKS
NEW RESIDENTIAL PLUMBING
ElADDIALTER �E] COMMERCIAL MECHANICAL
REPAIR RETAINING WALL El SIGN
EXCAVATE FENCE CHECKED BY TY;7E OF CONSTRUCTION CODE HEIGHT
DEMOLISH E] OR FILL R (_ x _FT)
PRE -MOVE INS
C P swim SPECIAL INSPECTOR AREA OCCUPANCY
REMODEL COMPLIAN E INJSP._ I POOL OCCUPANT
REQUIRED GROUP LOAD
WOOD STOVE/ r;;71 OYES
INSERT APT.BLDG EJ RENEWAL REMARKS
Q1 -
PROGRESS INSPECTIONS PER LIBC 305
um NUMBER OF STORIES NUMBEROF
UNITS 37
DWELLING
co 1__�, - 1 11 -
0 VATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
IO-C.P/y X�0,kz vz-f,
VALUATION FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY GRADING/FILL
Any.construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Worh is Started Within 180 Days ENERGY CODE
."Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
uW) harmless the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
cr
<1 wjh�tever nature, arising directly or indirectly from the issuance E
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CITY OF EDMONDS STREE1 FILE
APPLICATION FOR
ARCHITECTURAL DESIGN BOARD
OWNER/REPRESENTATIVE /
SITE PLAN- - -.- SIGN EXHIBITS
BUILDING PLANS-T-3F- ELEVATIONS
LANDSCAPE PLAN A-'-- ENVIRONMENT DATA
FEE q J(C7 RECT # �', -7 t C1
PLAN MODIFICATIONS TO FILE #
HEARING DATE_ V -71&
PHONE
ADDRESS ��Z (-7 -76-
aZ
!!�;9,44
0AW-3
ZIP CODE 9ffOZO
ARCHITECT/DESIGNER
PHONE
ADDRESS 9-A�Vc--� 70
/4z,,e
0,A.'
ZIP CODE
PROPERTY ADDRESS- 9///6
S'O -�7- Al&- Mk5 7-
Z-1-�Mov�
ZONING IC10
LEGAL DESCRIPTION �5. 19510-1 77ACY-�5
au�'? // a*
1-xceo?179� A)�-I--100 el 07�dlo/, \
PLANS SUBMITTED FOR APPROVAL:
1. Building Plans - Preliminary Final x Site Plan
Landscape Plan -Elevations
2. Sign Elevations Site Plan Landscape Plan
3. Modifications of previous approval
EXISTING USE OF PROPERTY I (11A'fAA, V — ZO 7
DESCRIPTION OF PROPOSAL Oy
/,�,o 6— tWll-
APPROXIMATE DATE WORK WILL BEGIN ON PROJECT 09
ESTIMATED TIME FOR COMPLETION OF WORK
RELEASE/HOLD HARMLESS AGREEMENTS: The undersigned applicant, his heirs and assigns, in
consideration for the City processing the application agrees to release, indemnify, defend and
hold the City of Edmonds harmless from any and all damages and/or claims for damages, including
reasonable attorney fees, arising from any action or inaction of the City whenever such action or
inaction is based in whole or in part upon false, misleading or incomplete information furnished
by the applicant, his agents or employees.
PERMISSION TO ENTER SUBJECT PROPERTY: The undersigned applicant grants his, her or its
permission for public officials and fhe staff of the City of Edmonds to enter the subject
property for the purpose of inspection and posting attendant to this application.
APPADBI/PFORMS
Z(Signature of Applicant)
11 g
MEMO TO: Building Division
FROM: Engineering Division
1pf ) 771
SUBJECT:
After review of the subject building permit application, we have the
following comments:
1 ) Connection to City water system required.
I
2) Connection to City sanitary sewer system required.
3) Right-of-way permit required for any work on City property.
4) Driveway slope not to exceed 14%.
5) Back water valve required if downstairs plumbing is below
elevation of upstream manhole.-
6) Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for containing all temporary runoff and
erosion on site and may pot inipalcot neig�boring properties in -a'ny
way.
8) Construction hours from 7:00 a.m. to 10:00.p.,-n. on we�ekdays and
10:00 a.im. to 6:00.p.m. on weekends and holidays.
9 . No burning of construction refuse by Fire Dept.
/Z I
STREET FILE
0111ZI-Z-4116 gpo A-e-11)
CITY OF EOMONOS
250 5th AVE. N. - EDMONDS. WASHINGTON 98020 - (206) 771-3202
COMMUNITY SERVICES
September 26th, 1986
Marian H. Salo
9331 Bowdoin Way
Edmonds, Washington 98020
Walter Bisson
905 South Lake Stevens Road
Lake Stevens, Washington 98258
RE: Property @ 8007 212th Street Southwest
Permit #860618 Demolition
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
The City of Edmonds hereby authorizes the release of the
demolition bond for the subject property. All interested
City departments have inspected the site and approved the
work and requirements.
Thank you for your cooperation in this matter, if you
have additional questions please feel free to call me at
771-3262.
�/��Jeine L
P t Coor
e 7�i
cc: FLD Industries
8613 193rd Place Southwes.t
Edmonds, Washington 98020
Ile
PUBLIC WORKS PLANNING PARKS AND RECREATION ENGINEERING
City of Edmonds/ Account Name (City/qontractor Last Name)
Account Number
Effective Date
The City of Edmonds, Finance Department. hereby authorizes Old National Bank,
Edmonds Branch at' 110 w.. Dayton, Edmonds, Washington 98020 to open a:
Savings Account bearing an annual interest rate of 5.25%
Business Insured Money Market Account bearing an annual interest
rate of 5.25% for monthly balance dropping below $2,500 OR an annual
interest rate which is variable for monthly balances maintained over $2,500
in the name of The City of Edmonds.
This account is in reference to contractor:
Name: /"�Z
uSl-gle--v
Address: ?61S
03/i2Z PZ-
SA/ &mat& 77F--&?S;7-
Tax Idefi�tification Number: sy-52
The interest earned on the account will be reported to Internal Revenue Service
under the contractor's tax identification number provided above. Statements on
the account will be sent to the City of Edmonds, Finance Department. FUNDS WILL
BE DISBURSED ONLY BY ORDER OF THE CITY OF EDMONDS, Old National Bank is only
providing a bookkeeping service for the City and is not responsible for'any
disbutes which arise between the City and the Contractor.
The account set up fee is $20.00 A charge of $10 will be assessed against the
account for each di�sbursement with the exception of the final disbursement which
shall be free of charge. All other standard service charges associated with the
account will be assessed against the account.
I have read the instructions set forth above and agree to the terms of the
account agreement.
dmonds Date Contractor Date
�City of E,
BUILDING DIVISION TELEPHONE/VISIT RECORD
DATE TIME
PERSON CALLED
TELEPHONE
RE:
FILE COMMENTS:
CALL TAKEN BY:
COMPANY
PROJECT
.Z]
VISIT DATE TIME LOCATION
PROJECTKt,YjUf (�4-fSX14'41 WHOM/COMPANY 141X,�� -5*4/6
SUBJECT 4
y I-e6e-jWJ Ak- �6&s-" &,v I-,Iw-
- J1v— X-i-al cqlled-- 4,�e, 9/& /wd-,r q,4w— &f- 4 11111c44 wfz> —
7-cog y Asa Ulu AX4 Sk lilles
& 1%,e- At &,v lt4pe 14
(-04/,qc�6- xej 41d-s, �Ao— Will 7*, O�MO �OMCI
— Will &fflmwK po�w A�v� -
FILE COMMENTS:
CITY REPRESENTATIVE: �,-T
CITY OF EOMONOS LARRY S. NAUGHTEN
MAYOR
250 51h AVE. N. - EDMONDS, WASHINGTON 98020 - (206) 771-3202
BUILDING DIVISION
August 12th, 1986
Mr. Walter Bisson
905,South Lake Stevens Road
Lake Stevens, Washington 98258
RE: 8007 212th Street Southwest
Abandoned Gas Station -
A field inspection on.August 8th, 1986, revealed that the
situation specified in our May 6th, letter for the property
at 8007 212th Street Southwest has not changed.
On May 16th, the Building Division%received your letter
sta I ting that the sale of the property,was.pending and
that such a sale would.result in an improvem . ent of the site.
If the proper ty has*sold.please inform the Building Division
of -the new . owner, if not, you as owner are tequired.to
correct the situation -at -the site as specified.in our May 6th
letter. There are two.suggested methods of resolving this
matter: 1) Apply for a ' demolit ' ion permit, 2) Provide the
Building Division with a written proposal and a schedule for
securing the building and cleaning the site.
Please provi - dethe Building.Division with your decision
within 10 days date of this letter.
Harold Reeves
Building Official
HR: j lg
CITY OF EDMONDB LARRY S. NAUGHTEN
MAYOR
250 5th AVE. N. - EDMONDS, WASHINGTON 98020 - (206) 771-3202
BUILDING DIVISION
May 6th, 1986
Mr. Walter Bisson 4
905 South Lake Stevens Road
Lake Stevens, Washington 98258
RE: 8007 212th Street Southwest
Abandoned Gas Station
The Building Division is in receipt of several citizen complaints
regarding the deteriorated condition of the property at 8007 212th
Street Southwest, Edmonds.
There are two suggested methods of resolving this matter:
1) Apply for a demolition permit, an application is enclosed, and
remove the structure, 2.) Provide the Building Division with a
written proposal and a schedule for securing the building and
cleaning up the site and then completing the work in a timely
manner.
Please contact the Buildfng Di*visi'on within 10 days date of this
letter regarding your intentions in this matter.
Harold Reeves
Building Official
HR:jlg
f-%
CITY OF EOMONOS
250 51h AVE. N� - EDMONDS. WASHINGTON 98020 - (206) 771-3202
BUILDING DIVISION
DATE: May 19th, 1986
TO: Mr. Artes A. Rainaldo.
Willowdale 11 Owners Association
21105�80th Avenue West #104
Edmonds, WA 98020
LARRY S. NAUGHTEN
MAYOR
SUBJECT:
Vacant gas station at 212th & 80th W
TRANSMITTING:
Copy City letter dated May 6th, 1986
Mr. Bisson response letter dated May 14th, 1986
FOR YOUR APPROVAL: COMMENTS
FOR YOUR FILE:
AS YOU REQUESTED,:
FOR YOUR INFORMATION: xxx
COMMENT AND RETURN:
R CVT EW AND COMMENT:
FOR rORRECTIONS AND
RE -SUBMITTAL:
BUILDING DIVISION
Zz
/Jeannine L. Gr`�f/f.
"'Permit CoordinaWr
EBD 11/83
COMPLAINTS MUST BE WRITTEN: NO VERBAL COMPLAINTS WILL BE ACCEPTED.
THIS FORM -MUST BE COMPLETE.
BUILDINd
0CMPIAINT SUBMITTED BY:
DATE Ap�t� 21, 1986
CITY OF EDMONDS
WILLOWDALE 11 OWNERS ASSOCIATION
Name: ARTES A RAINALVO: Ptesident
Address: 411q� 80th AVENUE W #704
-7' ,
77
Phone: 775 9619
ADDRESS OF PROPERTY TO BE INVESTIGATED: CORNER 212th 9 80th Ave West (Vacant Ga,6 StatZon)
Name of Owner: ??? I- 415,-U 5,7,
Address: ?99
Phone:
DESCRIPTION OF COMPI.A. INT : ' We consideA this pkopeAty dangetou a,5 wett as uns.�qhttq.
The den,5e gtowth o6 gia,5,s and weed,6 ptesent both a 4iAe and heatth haza,%d. The vacant
buitdina with tittet.btoken atas,5 and iunk vehicte.6 va,%ked theAe v)tesent a veAu Dotentiat
dange,,t to 6matt chit&ten who ate att4acted to ptay thete a,6 wett a6 teenageA4 4,tom,the
High4choot who 4ot whateveA tea,5on a4e .6een Zn and out o� theAe. I am su�cptaed that the
City o6 Edmond6 ha,6 attowed this eyeso4e,upeciatty on a main thotough4a,%e. It
deginitety toweA.5 the plLopeAt� vatue in thi,5 a�tea.
DO NOT WRITE BELOW THIS LINE - FOR CITY USE ONLY
CODE SECTION VIOLATION:
TYPE OF ACTION EXPECTED:
TD14E REQUIRED TO INVESTIGATE / ACT ON COMPLAINT:
RESULT OF INVESTIGATION: DATE:
TIME REQUIRED:
INVESTIGATED BY:
,BUILDING DIVISION TELEPHONE/VISIT RECORD
DATE R120 /8
PERSON CALLED J�K-r 574(l e-+4c COMPANY
TIME Vo-
TELEPHONE # 7-7F-0502- PROJECT AOCte�64SI7�flla'V
RE: )&4Wupe,�,h6 c-,4bi 40AA of-712- ;?/21)
Me, J-Ar\e4+C- G411M -�tL M �5 S9,10 W h0 Li wd4-, pip, 9)-s-c6/v-
Mle 6a0Al WAS �� VA) ly OlVe COIVI-�qCA--d !�JA /jlVd /V 44-S IV-5� Moved
6ft 1 �- /Vks SA10 �)ma ui—AD"�- 4� lfh�r S& woct/d. like Lo4le-s-
Movlk� f e-XP1,qkvfd 46 Nk 54nefk- , hm o ha-41,vi ml;6-, lzoollemwIs
12-5, 42-000 1 (omoAj-+KS , musf-chdf,�� sik e/c. .
FILE COMMENTS:
MWI--bt- f(fp'KO Vf-d C-Ad -('*"W All 4'WS ol*'v� YCf;'--r /4,,70) 0 SeA
P(A Cet )'�" sl /e 6 f COA/ cu-k e �c ) Aeed 741-le 4/-
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CALL TAKEN BY: R167
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VISIT DATE TIME LOCATION
PROJECT
SUBJECT
FILE COMMENTS:
CITY REPRESENTATIVE:
WHOM/COMPANY
May 14,1986
Harold Reeves
City of Edmonds-Duilding Division
Dear Sir;
This is to acknowledge receipt of your letter concerning
citizen complaints regarding abandoned service station at:
8007 - 212th S.W.
Edmonds,V,la.98020
At this time, we have a sale of the property pending..
hopefully, this will be completed within the next month.
The property has been totally vandalized by persons in
the area. -Not only did they steal all electric wiring, furnace
and parts —they also used a sledge hammer to completly ruin
the bathroom fixtures ... besides breaking every window and door.
They have used the building as a dumping place for trash,
the latest being an electric stove..I have had to go three times
in the past year to clean up the UarbaEe, broken glass and the
stove and take all of this to the garbage dump, at my own personal
expense.
I have no idea who oiirns the trailer that is now on the property.
Hopefully, the property will be improved very shortly. I
appreciate your patience, regarding the complaints...
Thank You,
Sincerely
V 3 V, 4
.IWILDINg 'Malter Bisson ?,
MAY 16 1986 905-SO.Lake Stevens Road
Lake StevensVla.98268
CITY OF EDMONDS
ASSET INFORMATION SHEET
P/NEW
ADDITION
RETIREMENT
HLE
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
et
DE NO
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
PROJECT NUMBER
PROJECT COMPLETION DATE
COST �;V4,
B.A.R.S. ACCOUNT NO. 6-3
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
�DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
Is G.L. E
REFERENCE DATE
VERIFIED BY
PROCESSED
BATCH NO. -
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