HomeMy WebLinkAbout108-110 N Vine St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date 1.:-- S- - 0 ;L
Time
Received by
(phone, person)
Location of Work to be inspected ) 6 '9 - I / D fl I// AJ~
Name of person requesting inspection I~ " I (c ;L
Address of person requesting inspection II -(11 cb- f3 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other I JJ 4.j--ttJ/-
INSPECTION NOTES
Inspected Date
Remarks
Time By
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RESTORATION REQUIRED
YES
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC 0 Other
D Repaired by City Work Order # ;( 0 37
[] Repaired by Permittee &CO~PLETE
D No Damage Found 0 INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)