HomeMy WebLinkAbout1823 W 5th St - Building
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . .
REQUEST:
Date 7 - ZD ~U0
Time
~ (0 AM I/O"", II
~ Received by ( {.{7C'-t tT. (phone. person)
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Location of Work to be inspected 0'::>
Name of person requesting inspection LJ .,-~ ~ "" H.
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Address of person requesting inspection Lei;, G('
Type of Inspection (circle appropriate one): I
Sewer Foundation Framing Chimney Plumbing Final
11"i- 13 Phone No. fn -</f?'11
Permit No. . ~
Sewer Excav. Dt~tJ,<_+c.r)
INSPECTION NOTES:
Inspected: Date ?? - :5 ~ D0 Time;;; : SO 111"\ ByOe veV( oS E..
Remarks:.A lU:w J x. S-/'S(' ..:S<.iJ'~ W~S i.vS17-Jled 50 -H-z ord
. rJiL~ 'tAt "u"'c5' be,;c,;; cro,Jdel J:J\. CL lvi-Ad r",vc Tire-e.
CL,,-d ((U,I<I'~_),- could In, n~lVcDved.
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RESTORATION REQUIRED
\
YES \
NO )(
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # S c;5 >9 - 5"(, (,
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)