HomeMy WebLinkAbout814 W 5th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . .
REQUEST
Date I Z - (z - D5'
Time 'I '5D f7Wl. Received by V-t'>"l"'t. $ c.. iEhone, person)
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Location of Work to be inspected 8 I C/ tJ 5-
Name of person requesting inspection .t2e'1 "1'~ C
Address of person requesting inspection Lo",- ~ Ya..v-d. Phone No <-{ '7 -'i84~
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Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth@+~
INSPECTION NOTES
Inspected Date I z.. -, z. -0 c;
Remarks ./Lefc....' red. 3 r, A.c
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RESTORATION REQUIRED
YES ;x: NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # :3054Z. - D5~
o COMPLETE
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)