HomeMy WebLinkAbout2140 W 6th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST-
Date 7 -{ q -0 <;--
Time 9' ;cJO A f~ Received by 7 ( /
(PhOne,~
Location of Work to be inspected :< / tj 0 vJ (; T "-
Name of person requesting inspection tU t..... fer &, ,,/ '
Address of person requesting inspection W / 7 ,,? J ,S- ~ 13 Phone No c/ I 7 - </ 5' ~/ 9'
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~ c--JC\. f e .r
INSPECTION NOTES
Inspected Date I - / 1- 0 <y-
Remarks
i 't': ,1 t? t.-t/
. <; e,/ V/ G-r
Time /;2 , (/l) /tfn, By 7/7
14/(a,~ fv /41ef~/
RESTORATION REQUIRED _ _ _ . _ _ YES NO
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SURFACE RESTORATION-
SURFACE TYPE 0 Unimproved DGravel
--(J------,---,----,--------
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o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # :~Q3 c.;6 - 05Y
~ COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)