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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date /0 - J.'/-05-
Time
;<;00 11m
f
Received by
7/7
~ person)
Location of Work to be inspected LJ 1 <) ,5':> fac e
Name of person requesting inspection (~,) c; t e r /h 0/.
Address of person requesting inspection /7,;)3.'5" i? 5/- Phone No. L/17 - 'lfi'/7
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. ~ 0ec..te I~
INSPECTION NOTES:
Inspected: Date 10;) <) -0 S- Time / / ; t'lJ -4lh By 7 I,
Remarks:
U?-e/le.,v wt'ttt!r ,<;",/V/C.~ la'/<' ('1/.;") f>O/?1 G....Jlh s'/"a h me/e-r
I
RESTORATION REQUiRED...... YES NO
*
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\I) L.,
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'U In
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\;$
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6
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC ~ Other l ~/) SOI/
Work Order # ]'o:Jc/6 - 01(
o COMPLETE
~ INCOMPLETE
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