HomeMy WebLinkAbout1814 E 5th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST_ ;}.Iv- 0 J
Date ~ Time
Received by
(phone, person)
Location of Work to be inspected I <g / Lf f S-f-A..
Name of person requesting inspection r LA.J I I I ~oC ~
Address of person requesting inspection ! 7 fit f- t3 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other fJ-Jt!" ~ y-
INSPECTION NOTES
Inspected Date
Remarks
Time By ~
01Jt~C1 ~(:if::~~()~I;; ~~ltr--
I jJf I ~L
~
~
f A
L 1
""'-' 35<6 I ~
I ~ ~
~ ~
'" c:;- +)~ ~
'- 51-,
"
~
tt? \J
VJ
SURFACE RE~ STORA TION
RESTORATION REQUIRED
YES
.-/
~
NO~
SURFACE TYPE
o Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC ~ f{ 6 ~her
W,-ork ~. #
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)