HomeMy WebLinkAbout120 W 12th St - Engineering
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date I). - s-- o~
Time
.2, (J?) t1 ~rl Received by
I
717
(PhOne,~
Location of Work to be inspected I ;< U G-J I J... T '-
Name of person requesting inspection We<L T e r () i'(/
Address of person requesting inspection 170:3 5 D (5 '5;-
Type of Inspection (circle appropriate one)
Phone No '-/1 7 - i "if'! ~l
Permit No
Sewer Excav ( Oth;;:) {~tA.. t e .r
,,-~...~...">"
Sewer Foundation Framing
Chimney Plumbing Final
INSPECTION NOTES
Inspected Date I ') - ~. 0<)
Remarks
Time
<f 5u JJ/J'7 By 7/7
,
f}. ''- ma,1\. 6r -e~1,"- (<',LJ/ace d ~ \ or t/;...e
RESTORA TION REQUIRED YES Y NO
.~
rJ. " C.r -
I;) TI, '-
4J.. \I ~
~ ;<:t. ~
\) l):) ~ ~
JCftj' ~ ~
- ... ,;1''' a .-
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved OGravel o Asphalt OPCC ~Other IOf SOI'j
o Repaired by City Work Order # sO J lj) - 0'5)
[] Repaired by Permittee 0 COMPLETE
D No Damage Found ~ INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)