HomeMy WebLinkAbout1434 W Lauridsen Blvd - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
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REQUEST
Date q- ?-~ - VD
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
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INSPECTION NOTES
Inspected Date
Remarks
Time By
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RESTORATION REQUIRED
YES
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NO ~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # J &6 Y
~PLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)