HomeMy WebLinkAbout233 E 6th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . . .
REQUEST
Date
3 /2 (~..... I
Time
A--rV)
Received by _R~ T
(Phone,8
Location of Work to be inspected ;;; .3 3 E. t, :(~_.
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~ .~
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INSPECTION NOTES
Inspected Date 3 - I 2. - 0
Remarks
Time
A (1'1
By /I/}:j
RESTORATION REQUIRED
YES
NO
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC
D Other
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
~ COMPLETE $7- ~)..I M~ 3-?-7-l>/
1] INCOMPLETE ~
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)