HomeMy WebLinkAbout4312 Newell Rd - Engineering :' CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date Time Received by (phone, person)
Location of Work to be inspected W ~ = - ,'A: ,
Name of person requesting inspection ~:,~ ~* ~ ~, ,: ~ · ~ ~
Address of person requesting inspection ; ZT//~ : · - Phone No.
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav.
INSPECTION NOTES:
Inspected: Date ~ ~ ~-- '~: ' By
-~ ~ -, ~ Time ~. ~'~ ,; ~
Re ks ~) ' - ' ' ' . '
RESTORATION REQUIRED ...... YES NO
~: ,,.
SURFACE RESTORATION:
SURFACE TYPE: [] Unimproved []Gravel []Asphalt []PCC []Other
[] Repaired by City Work Order #
[] Repaired by Permittee [] COMPLETE
[] No Damage Found [] INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
........... INSPECTION REPORT ...........
REQUEST:
Date Time Received by (phone, person)
Location of Work to be inspected zz/~/~ .Z~/'~'~Z_4/
Name of person requesting inspection ~/_-~T,~- ~
Address of person requesting inspection ? ? / ~ ,~ ~/~--~ ~ 7T', Phone No. z/'~-~
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date ~._ ~z_ ?/_~ Time
Remarks: ~<~ d~,~---~- /~ ~ ~
RESTORATION REQUIRED ...... YES NO
/
~URFACE RESTORATION:
SURFACE TYPE: ~ Unimproved ~Gravel ~Asphalt ~PCC ~Other
~ Repaired by City Work Order
~ Repaired by Permittee ~ COMPLETE
~ No Damage Found ~ INCOMPLETE
(Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE)