HomeMy WebLinkAbout1040 E 4th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney
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,
Phone No.
Permit No. /t/tf'4
Plumbing Final Sewer Excav. Other ~~
INSPECTION NOTES: ~
Inspected: Date I P f.l ~ .
Remarks: fl 0 /!; {/ I fJ
Time
By
~
~
~
~
~
\y
RESTORATION REQUIRED. . . . .. YES NO
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved DGravel D Asphalt D PCC
D Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)