HomeMy WebLinkAbout1101 1/2 E 3rd St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS //tJ//f E 3n:{
. . . . " . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date !O~~~O'S Time 7 /It-v( Received by !kvlI'liS E- (phone, person)
.
I10tl Egr-d
Location of Work to be inspected
Name of persori"requesting inspection' .PCVl '" I'~ E-.
Address of person requesting inspection Lo ('.LJ Y CA. r J
I
Type of Inspection (circle appropriate one):
Sewer Foundation Framing Chimney Plumbing Final
17<fO Phone No. If''7~<{N1
Permit No. C7~?:5~
Sewer Excav. Oth~<L+el
INSPECTION NOTES:
Inspected: Date lOr ~ .....0 S- Time I Z- ~ :; 0 PM By
Remarks: t:rl 8''' Il L. IvL ro.::..d 0"'-'1 J bo re ,," f'-E...
Av<4 ~t i"'-Lt-e....... ~ Ci..+ frofud'f .
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RESTORATION REQUIRED . . . . .. YES X
NO
SURFACE RESTORATION: b' )( 5' I
SURFACE TYPE: 0 Unimproved 0 Gravel % Asphalt 0 PCC 0 Other
o Repaired by City Work Order # S D?" S' - I z. f
o Repaired by Permittee 0 COMPLETE
o No Damage Found 0 INCOMPLETE
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APPLICATION FOR WATER Wo.'~f3()5 tf& - / Z. (
City Water Division
Port Angeles. Washington
,20_
I hereby apply for water to be furnished in accordance with rates and rules of the City for the
following premises: mA"l.iN~
Name of Applicant: ~teueh OJ SOh ' /41 ~ S. 't-II 51"
/ IOII/~ E:.. "3l"d ~z.-1Z./3
o,,:;oooS,{C'izsax.o 775- 14Z?>
Renewal 0 New Servic~lk...2 i bLot /0 Add .s C..suRb of
d_h .JJ '""'of 19 .aM 00
Size of Service_' X ~/ff Meter Numberr~ -If'"
Address:
Service Left On 0 Service Left Off 0 Signed
Installed by
RemarkS: "Pe. of l'o\ \,. :d. 0'5- gOO
'5epe.r-aJe '2." 11 J
~ 71'5E!
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT . . . . . .
. . . .
.....
REQUEST
Date 10 -"5 '-C)'S
Time 7 /1 t'-'i.
Received by tJ-enl--lIS E- (phone, person)
Location of Work to be inspected (I () (.f E 5 r-d
Name of person requesting inspection Pe t-1 H / S E...
Address of person requesting inspection Lo (~.L1 Y CA-.r J
I
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
17<1- 6 Phone No if tf ~ '-I~-{(-7
Permit No ~
Sewer Excav Oth~L.+e ~
INSPECTION NOTES
Inspected Date I c) ,- ~ ~u S- Time I Z 50 PM... By
Remarks ~'- f'J 8''' A L {VL r oc~ 00.- '(, ho ~ e. 1''' !<E
~VlJ Szt 'l~i-e.r ~ ~-f f(~f~l-tt /
D-<"HVll') f.
Lhi d e.- ...5 {d I:? ~'4.hJ I,
RESTORATION REQUIRED
YES X
NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
[] No Damage Found
,. .
6)(5"
ft Asphalt 0 PCC 0 Other
Work Order # 3D3'-18'-/zl
o COMPLETE
NCOMPLETE
()
wate/
STREET SUPERINTENDENT
(DATE)