HomeMy WebLinkAbout1605 E Front St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . . .
,/ ' --.--
;1
REQUEST
Date ({ r- {'1 r 0"2-
Time
Location of Work to be inspected 16C' S
Name of person requesting inspection V
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney
Received by
(phone, person)
E, Fro,^- t
[:c's I~+O~
Phone No
Permit N~
Plumbing Final Sewer Excav Othe I ,
INSPECTION NOTES
Inspected Date I (- rc;-D '- Time~
Remarks IVL-Stc...U ,es'~ffe.rs a~ keL.\...-)
~ LI .e. 13 IY"{ -I" c; -E:. (< rvY"- (
By P 6~ (~j~
/'<A.Q..t- ev~ be '(: €- c.3>
RESTORATION REQUIRED
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
YES
NO X
o Asphalt OPCC esOthe~ ~
Work Order # 2 z C) ()
~ COMPLETE 4C:j e cf ii. 205 (
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)