HomeMy WebLinkAbout1935 W 10th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date t.f -G:.r 0 5""
Time 7 /I Wl
Received by ()-f?f,(IA.:S E - (phone, person)
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Location of Work to be inspected 19 3. '-:) w 10 --t-S
Name of person requesting inspection O.e..1.Vl/ ~ ;C.
Address of person requesting inspection (0 r rJ Yo...r d { 7 ~ 6
Type of Inspection (circle appropriate one) I
Phone No 'f I 7 - i.{ 8'-l 9
Sewer Foundation Framing
Permit No
Chimney Plumbing Final Sewer Excav Other Wa.. +e r
INSPECTION NOTES
Inspected pate L( - & ,- 05
Remarks Re t::Jc. 1'-- e J Z' c ~T
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Time L _ 5 D {JtW\. By D< Hvt \.S E
M4./ V\, tJ i ~ + k cZ G:, .j,hS . S tr e ,:JCA; r h"y'\d
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RESTORATION REQUIRED.
1
YES
NO X
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
D No Damage Found
o Asphalt 0 PCC D Other
Work Order # g054.'1--o 5 (
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)