HomeMy WebLinkAboutSpecial Inspection Fire Damage Report 2003-11-1
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FD-016
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
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TO:
Building Department
Date:
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FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of Owner
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I (Dwelling, Store, Warehouse, etc.)
Type of Building
Estimated value of building $
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Estimated loss to building $
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Date of fire
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Location of damage to building
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(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire h/"".. ZU-'>{ ro...l4:.1.. j
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard
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(Wiring, Outlets, etc.)
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Signed
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CC:
V:IFORMSJDs Fire DeptIFD-016 FIRE DAMAGE REPORT.doc