HomeMy WebLinkAboutSpecial Inspection Fire Damage Report 1983-8-12 (3)
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
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TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of owner j!J I ~ p r-f ,&, 1, ,,"11 n A,( ,
Type of building J{e~l.~.;-
(Dwelling, Store, Warehouse, etc.)
Estimated value of building S
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Estimated loss to building S /~f>-t? '
Da te of fi re t'- / .1 - k ~
Location of damage in building ~A ~Ul~ /J)4f...l e~-
(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire
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(Burned rafters, Beams, Joists, etc.)
Additional pertinent infor~at;on
Electrical Hazard
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(Wiring, Outlets, etc.)
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Signed
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