HomeMy WebLinkAbout305-305 1/2 E 2nd St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date {- 2/- QS
'~
Rt/
2 ~d
(phone. person)
Time
Received by
Location of Work to be inspected 3C>~ - :505 J.?
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one):
C::
Phone No.
Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NO;;'f~:. \ ~
Inspected: Date ~
Remarks:
Tim'----fr4--BY ~
~;;::
~tcS.
~I~)
RESTORATION REQUIRED . . . . .. YE
'30s-~ E 2 ~
No
NO
H€cLi.~~ 'SeWer- I l,'",- e...
I €<l.k. "'-3
J l \ ~ e;t/}"'3j
~",e...- u..,~~ t. "7 ~~1.C€""IAS
7
eo
S'o~
c- 7.. "....d
'YY\ a.. y
~ U~;rJ
~~Vb Gcle;ufJ-D .
~~~~~
C!..P lJ.-O~ J-, DU [ ~'(VJe ~+1-
SURFACE RESTORATION: :0<1--- c;,,~f)
SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC
*Y~'"P 'Dr~
1.0"- 12-"
VI&- \ oj B:
-+0 iX~6VL
3oS- + 1h....
fti.?-G
~
1A.Jl
r.o-. \L __ ~.
/J-.-l ~cN
o Other
[] Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)