HomeMy WebLinkAboutOccupancy Correspondence 1988-8-12
CITY OF SPRINGFIELD
Department of Planning and Dev~pment
Building Safety Divis'lh
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPE~N
APPLICATION >
DATE:
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JOB ADDRESS:J:.5I'7 _c:;, A.sT LC;:~qrH"'/4 t'JR_ <17t/7?
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OWNER: J{ /11.1') J. J" /11 N.<; n.#
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O\VNERS ADDRESS: .JS..../7 ,<:;.J SI . <:;~~'J,vJ r/~M /?R. '9'?J'??
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APPLICANT:r<tlh~1-7~ j,07l,,,,&~ (R~"v~t sToTE PI'''!,-JI"" ,.Rnof J?Ep,,/n ')
APPLICANTS ADDRESS:l22.1l .S. A .<;, .~~...I .lJn. 91'{L?
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: '7Y I}- t1,J{,;l. '7 tJuJN~1(
RAh<,:~T.J L,,-,ltM"'R ?:J../"-t2~,t;'~
PROPOSED
USE:ff^fr>./I~r,) f?,O/l~_ Mjf",. ,<;'t1/~.<; of'Rtf,PJ?/R
A $ 35. DO INSPECTION FEE IS REQUIRED AT TI-IE TIME
~~ OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OllliER OF THE PROPERTY TO
BE INSPECTED.
/lJ./-d h~~
)s~~R~F PROPERTY
FOR OFFICE USE ONLY
~
O\VNER
DATE OF INSPECTION:
RECEIPT NUMBER:
12--1 V ~
f"'-- , 2... -g-~
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
DATE PAID:
COMMENTS:
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