HomeMy WebLinkAbout238 W 6th St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST.
Date J ')- / 7-0' ~-
.
Time
7 .' cJO f rY\ Received by
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(~person)
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Location of Work to be inspected J. J S CA/ G T L
Name of person requesting inspection vv e:-vt e, 0 I v' .
Address of person requesting inspection 17v:3 S c::> B Sf Phone No l.j 17~ V$f9
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~ c::::..-va. Ie r-
INSPECTION NOTES
Inspected Date 17 -/7- 0 S-
Remarks
Time
~; VlJ l/Yl
By
7/7
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RESTORATION REQUIRED . . .. . YES X' NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
o Repaired by Permittee
o No Damage Found
/
Asphalt 0 PCC ~ Other
/
Work Order # JoJ'f~ - 06/
o COMPLETE
% INCOMPLETE
c-o~ci<:.ic.
J J
/ v/3,f)! D5 T~
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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