HomeMy WebLinkAbout1207 E 6th St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST /'7
Date {1- )'g-O/
I '
Time
IX
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other LA jc'L,--J=g~
)~b7 :f- 6-/11
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( 7 f/ I ~ J"-2- Phone No
INSPECTION NOTES
Inspected Date
Remarks
c\
~
~
~
~
'0
RESTORATION REQUIRED
YES
NO
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> 4- 55' 7'3'
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
~ 0 Repaired by City
/5'" I Jl'e ,,?] [] Repaired by Permittee
/ 1 0 rrJ: 1 /j/ 0 No Damage Found
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sphalt 0 pcc OO_t!,er
Work Order # q 0 5h
rSI COMPLETE f~\-I'\::"J'-'\ i-e, 0'-\\.J"~\ _\ lJJ, \' ~
o INCOMPLETE ~ 0 \ Jv\ \)/ \O:-!S - 0 -3
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(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)