HomeMy WebLinkAbout402 S Valley St - Engineering
CITY OF PORT ANGELES ;-IT~ uJP 7z-'7t)
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date 7 - "3 /- 0 '3
Time
Received by
(phone, person)
Location of Work to be inspected 40'2. S V ~ [ t j
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
e Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date ..)~ Time
Remarks ~-t.p tQc..Ld~.Q.kvc~J ~YY\ 'Dt~+O
.:5QJL aAD.-C.Nd r}rCLlU U18
By
2.0' WtSt of YfItlin l.f\vcJlt:r
RESTORATION REQUIRED
YES
NO
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SURFACE RESTORATION
SURFACE TYPE D Unimproved ~Gravel
r8l. Repaired by City
[] Repaired by Permittee
o No Damage Found
D Asphalt D PCC D Other
Work Order # 72-7 D
ffi- COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
t+rti' w': 72.70
/."' .~
q') l ".. roBe
.,
571
'f
6- concrete
4- concrete
,. l\G
li pvc
. 4- co ncrete./ 4 - pvc femco
201
. 4- Clean out
8- Concrete
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