HomeMy WebLinkAboutPermit Housing Code 1994-1-4
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COURTESY INSPECTION APPLICATION
(RENTER REQUEST)
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: U (l m :OJL\~ 4-, \ C\. C\ 4. JOB NUMBER: Q471JU
ADDRESS~ INSPECTION: ~4~~ \ .A\ ,\ 0\. ~'i1r 001--.;
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OIJNER: .f1iJ f\. \..\:::\\,\\/,o.h-t mCiJ-\~. . PHO.NE NUMBER:
OWNER'S ADDRESS: q~\ 'n \ DCiJ \, 0 \\ ~ -f\ 0 ) ~ _ Rrn..-.l
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RENTER:\ dx'\\ ~ PHONE NUMBER:
SIGNATURE OF OCCUPANT (RENTER):
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
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TYPE OF DWELLING: SINGLE FAMILY I I DUPLEX I I MULTIPLE I I ~
BRf:EF DESCRIPTION OF MAJOR PROBLEMS: C\'lO'?>?l1 c:A-\ n\CJ:D)
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FOR OFFICE USE ONLY
DATE OF INSPECTION:
COURTESY LETTER SENT:
NOTICE AND ORDER ISSUED TO OWNER:
DATE FOR COMPLIANCE:
COMPLIANCE OBTAINED - DATE: