HomeMy WebLinkAbout2020 W 6th St - Engineering
()c..v~ ~oOI- I y ~'Z..
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS q E I /
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one) Permit No / /38
,
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other 6-; c:\_~
REQUEST
Date / - _-;1') - Cl 1
Time
INSPECTION NOTES
Inspected Date
Remarks
Received by
(phone, person)
2c
LeJ 6+~
'T10 1\. c0f3
-1 f 11 "f- - Phone No
I-I '^
-Ae,
Time By
~-n) >:!-( d ( IJ -.e '-'--, 1 JC >h C L\ c<- t-c:1---
5----PVi ) l~ ( .-e
~
I
YES
I'-
/
NO l/'
RESTORA TION REQUIRED
L.&4BF2-7~7q/7
.'7 ~ f,(t.~. J
(7....... 1',' ?
,...... r- -
~~~.---- --I
---- ~-
\
~~~L~
~
~
))1'
Lth
C1
'~
~~
<y
r
~~'".-
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
C1 Repaired by Permittee
CJ No Damage Found
Work Order #
~OMPLETE
o INCOMPLETE
o Other
j 7x :L-
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)