HomeMy WebLinkAbout1121 Madrona St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST:
Date I 2 -c, -0 ')
Time I Z : ">0 JOy", Received by ~VL~5 IS. (phone, person)
Location of Work to be inspected I (2 / M~r 0 v1c"\.
Name of person requesting inspection De"""" S c .
Address of person requesting inspection ~-rD Yc...v-cP., t7et-~ Phone No. L#7~'1'8'-1'1
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Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other@ ~+-e0
INSPECTION NOTES:
Inspected: Date /2-..-c; -0"> Time Z: '50
Remarks: f(e (JA" r 2." Mo.l'", h'--D ke "1. "'- + ~vb
Lovfl'js . ""-"1. f [(" 0 -P S<-h.. 80 P-v.C-.
By DeV1.VlfS f:. '
fA) ,,+ k 2. /j,ess ev-
RESTORATION REQUIRED . . . . .. YES
NO X
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC
o Other
o Repaired by City
D Repaired by Permittee
D No Damage Found
Work Order #
D COMPLETE
o INCOMPLETE
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