HomeMy WebLinkAbout1322 W 10th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . . .
REQUEST
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Date :) ~ '- J L' <>
Time ( I 5-c 17 ~ Received by D<' "'-II\- l<) 2 (phone, person)
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Location of Work to be inspected f L tA., 0 - .;> .
Name of person requesting inspection l)t:> vi. i-1 · s E
Address of person requesting inspection Phone No 'f I 7 - '-18 <<{- ~
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth~~
INSPECTION NOTES
Inspected Date 3 2 3 -cc;- Time
Remarks ke /h~ I>' i? A b^,-c k 5 i6.e.- o~
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RESTORATION REQUIRED
YES
NO X
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # 50'5 'It.:. - cL 3
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)