HomeMy WebLinkAbout617 E 5th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT. . .
REQUEST
Date ) -. A -D tJ-
Time
Received by
(phone, person)
Location of Work to be inspected 6 / 1 E: ) j~
Name of person requesting inspection f (,0 ~ ( (vy
Address of person requesting inspection /1 t/, t b Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other L<-i\.~
INSPECTION NOTES
Inspected
Remarks
Date
Time
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By
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RESTORATION REQUIRED
YES
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SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel 0 Asphalt D PCC
D Repaired by City
[] Repaired by Permittee
o No Damage Found
Wor~rder #
[pCCOMPLETE
D INCOMPLETE
D Other
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(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . .
REQUEST
Date 0 J - D2 ~c) 2..
Time q ,'00 I4--n'\ Received by () tV t/l S, A-. (phone, ~.so~l
Location of Work to be inspected {o II E 5~"S.>+-,
Name of person requesting inspection C')vJ-i.1\ So.
Address of person requesting inspection to Y(.> j o..r d. Phone No t...J "1-0\ c., c:>
Type of Inspection (circle appropriate one) Permit No /2. Z!
&J Foundation Framing Chimney Plumbing Final Sewer Excav Other
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NO
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SURFACE RESTORATION k 30'7 ~
SURFACE TYPE D Unimproved 0 Gravel D Asphalt 0 PCC ~Other ~9~~_~
D Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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