HomeMy WebLinkAbout15th & C Street - Engineering
...
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date q - 7-04
Time 7 Av<-<..
Received by j)~I1.'1 (5 it:::... (phone, person)
fI-.
Location of Work to be inspected (f:) - ~ c- S-<lJ"
Name of person requesting inspection tJe",vt ,S ~ .
Address of person requesting inspection (""",n /',() ,!"" J
,
Type of Inspection (circle appropriate one):
C6rvrer.
Phone No, ~
Sewer Foundation Framing Chimney Plumbing Final
Permit ~
Sewer Excav. Oth r WtAT-e-r
INSPECTION NOTES:
Inspected: Date c; - 7 - 0-+
Remarks: I?~ 0", I r 2-" C.I.
I
Time It AWl
VtA""- " VI t.J'- t-L. c;: .5 . 5 '
By IJe )0"1.1/( (~ E..
re,o<>..,f b'\.v1d,
I
RESTORATION REQUIRED . . . . .. YES X NO
] I ~
~
:0
-'3- 0
,2"CI
N \j)
U
, t/'"
, uJ
~ ~ ~ 1'5 - s;t
rie.c< k. 3 ~ e et \.YD'M T -
[eX .~ 3~ c.( .
~ ""0-
3i' paf I
, , 'Q~ a. - IS -ClLI
o Repaired by City
o Repaired by Permittee
[] No Damage Found
,~ JIYed i0/~ 71""-
(~_ontinueon r~verse.si<!e_if_nec~....,,!y)_ _ _ _ __
~~Y..0>
~ Asphalt 0 PCC 0 Other
~k Order # (382 'is- o~o ..'
ill<\ COMPLETE ):~6~q .t;t: I
o INCOMPLETE AK:s>.. Q~~ \D.'\-~
~ ~ /
<::i:= ' \. U(
.!)() , L\ "\ "K- II
STREET SLJPFRINTFNnFNT mATFI .
SURFACE RESTORATION.
SURFACE TYPE: 0 Unimproved OGravel
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date q - 7-04
Time
7A"",-
Received by j)eI1Jl' 5 t:.. (phone, person)
Location of Work to be inspected (5 ~ ~ L S.W.
Name of person requesting inspection !J"'J1v1 ,S F""
Address of person requesting inspection ("',f')/, tJ y",,-J
I
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final
corMer.
Phone No. ~
Permit N~
Sewer Excav. Oth~
INSPECTION NOTES:
Inspected: Date C; - 7 - 0 '+
Remarks: 12e. ()" \ r 2" c..I.
- I
Time / (
w\.."'- ,- VI w.--rL
AM.
c.: 5.5.
By IJ? Y1 Vi. {5, E-
re .o""f b,\.v1 <L .
I
RESTORATION REQUIRED. . . . .. YES X NO
'I ~
, ~
:0
__0-
2."CT 0
N \f'I
u
, tk
, iJJ
~efA k. 3 ~eet ~,rD':T' IS - S;t
-
-~
Z.'CI '3~ '-1"
'-" -v-
3{ , Paf I
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
~'~~c;
){j Asphalt 0 PCC 0 Other
Work Order # (3 gz ,? O~D
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
I
STREET SUPERINTENDENT
(DATE)