HomeMy WebLinkAbout616 E 9th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date / Z - Z( ~L'<)
Time
I ritA
Received by
06UlfS L
(phone, person)
;...---
Location of Work to be inspected t; I ~ & - "'7 .~
Name of person requesting inspection [)c~#'t (..21 ') E.
Address of person requesting inspection (Jc, ,.... (J ~L ()j
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
I? of- /1 Phone No 1('1 --- t/f/'-I9
Permit ~
Sewer Excav Ot~J~ '\
INSPECTION NOTES
Inspected Date / Z - 2 I ..- 0 ~
Remarks Ke ;1.c..: It/"' Z (, C-I
,
Time
tvl c... I "'-
Z fJ/~
v..) ~ fL t1'-..
By VCHVlI~ C
'5. S t/' <!:_tk I r
f
bc'VLd 1
RESTORATION REQUIRED
YES ~ NO ./<-.-
~
- ---tfA
~ ~ q -
~ ~
~ I ( ~
.~ 2" C L ~ Vi.ep t 'L(D~ -
---- '"
~ ~ ~
J
6/6 \u
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
D Asphalt D PCC D Other
Work Order # ~c3'-l'L-C'={
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)