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HomeMy WebLinkAboutSpecial Inspection Fire Damage Report 2006-2-7 . c..cn.';;),~ - (XJ \<01 .7E)~ '35 3'~ 0 3~C5D FD-016 FIRE DAMAGE REPORT OR ELECTRICAL HAZARD TO: Building Department Date: Z.J '11'{)~ FROM: Springfield Fire Department SUBJECT: Structural Damage to Building Name of Owner l-~( \ L-\ S A Sf c.o\-. 1l: I c\' 1 1---1: //.5 reM.~ Address or location of building Type of Building 4[)~~ 13. I (Dwelling, Store, Warehouse, etc.) Estimated loss to building $ ) 0 L( lll/n{~ . I L( )0. DDu COG Estimated value of building $ Date of fire Location of damage to building k;hL c.... P." I ^ bil-l-h t<Oc...r~h- P lr k,~", 1""':>0 It 1W\. l.0j1},J .,t Lc (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a result of the fire l.".'\M,,,,~cl C1"'r-rl j ,,; ",h (Burned rafters, Beams, Joists, etc.) Additional pertinent information rJ C. ,,vi "'1"" c!.. ,,)c.k.r {Ji~';vc." I J 1-,p>~ \... V\,'~ r! c "'^ cd1 J. d \ , IA)'i1I\.J (Wiring, Outlets, e~c); Signed} fI y. r1/~ o n. l~ H--c H kLN\~ ....+- Electrical Hazard CC: V:\FD_FORMS\FD~16 FIRE DAMAGE REPORT.doc