HomeMy WebLinkAbout1334 W 4th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
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REQUEST:
Date 1- t,. ~ 0 (
Time
Received by VO,t..k'5 t::.~ (phone, ~son)
Location of Work to be inspected /53'ri W. L{-tL.-
Name of person requesting inspection t/tvUtlS E..
Address of person requesting inspection I 7~ of- 13 .
Type of Inspection (circle appropriate one):
Phone No.
Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date
Remarks: t<.ene.,u .~eru(~~_
Time By
beL... 'I'\-d '^'lei-e ,,- . LVS -tv'^^- e r t e c: lc.
t~ 6~ I 1331 ro.
1.0.4
, ~ L-fAK.
1\
1." cT.
~ iii? Alley
RESTORATION REQUIRED. . . . .. YES
NO .K.
SURFACE RESTORATION:
SURFACE TYPE: D Unimproved D Gravel D Asphalt D PCC
D Repaired by City
Cl Repaired by Permittee
CI No Damage Found
Work Order #
D Other
/8111 T
~ COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)