HomeMy WebLinkAbout1316 S B St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
.....
. . . .
REQUEST
Date g - 10 -oS-
Time
Z fJ IV\. Received by D-eA-\..VL IS E (phone, person)
location of Work to be inspected I S ( ~ -S D
Name of person requesting inspection D-'l':V\.~ ~s
Address of person requesting inspection C.:;) r f
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing
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Vc'-.rJ, ( 7.... B Phone No 'f I 7 -Lf ~q Cf
Permit No ..- ......"-
Final Sewer Excav Oth~Wc~~e r ~
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INSPECTION NOTES
Inspected Date Time By
Remarks .t<ejJl"-ce .....~.+e~. 5e-1/-er '-'pled. aut by b6..ck""',,- (f""'-+,,-- )
LCK.+"-..:L+or
fVLe-+e.r IdLt.\.+\ov\.. r12.~c:o:..i.lA..'S +-k .:j~~
RESTORA TION REQUIRED
YES
NO x....
~ 6~
{}- 453 '- ~.
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t.: .{...
1.[\ S -f L.. V)
~ t,.J ( - ~
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # SO 34' --0 f, ,
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)