HomeMy WebLinkAbout102 W Front St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
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REQUEST
Date 7~ Zlc.-D'-\
Time ~ 5 00 A ~ Received by be "I. '" " s E- (phone, person)
location of Work to be inspected i 0 z u.J
Name of person requesting inspection j2.vr. VZ (s
Address of person requesting inspection ~C> or IJ
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~Inspection (circle appropriate one) Permit No
~ Foundation Framing Chimney Plumbing Final Sewer Excav Other
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Y O-Y j I ytl. t- 8 Phone No t.( ( '7 ~ 'i S'l/ 9
INSPECTION NOTES
Inspected Date 7 ,.. 'Zf.c,"- 0 L(
Remarks R,p r'--.. tttAL l .5e4.) <z r
Time .3 DD ,LJh.--t By D~t-rj/{f'S E_
C.61A.l?C-(!QCA..... ,0 r i r,,/ 5e0er ivlc...1 V\
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RESTORATION REQUIRED
YES NO X
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order # 22 ?&Jo -00 f
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)