HomeMy WebLinkAbout930 W 10th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
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REQUEST
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Time
Received by ;Jet-a1 ('S E' (phone, person)
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Location of Work to be inspected I...J t;V
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Name of person requesting inspection / ,- .D
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
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By
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Time
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Inspected
Remarks
Date
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RESTORATION REQUIRED
YES
NO >I
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130 w.,ot15
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC
Work Order # Iff /3
M] COMPLETE
o INCOMPLETE
o Other
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)