HomeMy WebLinkAbout131 W 12th St - Engineering
REQUEST
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Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. INSPECTION REPORT. . . . . .
Received by ~
Time
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(B, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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PhoneNo 4.Sc.!:?-'/fsy C
Permit No C
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s.ee% er. Foundation F. raming Chimney Plumbing Final Sewer Excav Oth.. er. . ~
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INSPECTION NOTES K~ ~a K___ ~,u '
Inspected Date
Remarks
Time
By
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
D Repaired by Permittee
o No Damage Found
Work Order #
k:f COMPLETE L( -),,3 -cv /h 14
o INCOMPLETE
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STREET SUPERIN EN DENT (DATE)