HomeMy WebLinkAbout6th & Chambers - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date /0 - I (r 0 5
.
Time
7: 00 AM..
Received by
711.0
(phone, Q
c,'t/, ~
Location of Work to be inspected _
Name of person requesting inspection W'l te-V"
Address of person requesting inspection 11 () 3.
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing
CktLlV1 h~ r 5
Dll/'.
S. IS S+-.
(s. E. (erner )
Phone No. y 17 '-{ S' Lf ~_
Permit No.
Final Sewer Excav. E> t~ r-e.r
INSPECTION NOTES:
Inspected: Date /0-11- D5 Time '2:00 f'J-\
Remarks: Xhsh"lleo\- I'lLW .fIre bt'1Jral>l..t' a.~\d
h."IdrclVl-t <-(Xl pq+c~ i'" blo-c..L i-z>r
By 7 1&
reMOv-eit
{'> I c(
RESTORATION REQUIRED . . . . .. YES
NO )(
N'I' ..,.- . (
~,k '{2." C.r
s\
(,9'
C. 73' 1
V\
(A ~. ~
VVl ;.,
\? ..
e
(
.5
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
D Repaired by Permittee
D No Damage Found
~ Asphalt D PCC 0 Other
Work Order # 303 '-11 - 0 i LJ
EI COMPLETE
D INCOMPLETE
_~_W4,,-l t ~,\.5 bee.Vl.P1X:-€-C\.
I Continue.on.reverse.side.if.necessar.vJ
CTDE:II::T CllDCDllUTCAlnl:::lUT
InATl:\