The URL can be used to link to this page

Home My WebLink AboutOccupancy Application 1984-12-13 CITY OF SPRINGFIELD Department of Publ ic H, ..<s OCCUPANCY INSPELdON Building Safety Division 225 North 5th Street APPLICATION Springfield, Oregon 97477 " 726- 37 53 (B us.) 726 - 3769 (I n s p .) 'JO'IJ ~ - ~ 'I () 9 / ~ "DATE: /2-//3') 7L/ ' , JOB ADDRE;S: _/:);;~ 1JJ f1P.Alf"eJ);{;IItL E u . OWNER: "&od fO--4A~___ ~~l.A.~':'" ~ 7<10 'O~80 OWNERS ADDRESS, ~".fP.~ t(J.; (O/l---ufauJat;. S12flt( O~97Y7"; :,' APPLICANT: 7eJ)D,' f3e;r(( / " ' '.-' , 'APPLICANTS ADDRESS:R1il/J-/ :("tfJe,-nvl/ ElUSeNe, 01( 9Q4<O~ """"'" , .. . FOR ACCESS TO PROPERTY--PLEASE:INCLUDE TELEPHONE NUMBER: ~~~7-- ~:sL/ 6ft::: L?~ P~e~/( 07 R/A-/N&J.iU tl- T (}.eN"kIVII/IHL (',"e~()cdZ. PROPOSED USE: PI/OTo L-I1fS ' A $30.00 INSPECTION FEE IS REQUIRED AT THE TIME " ' OF APPLICATION' 97~CJI fJ'hMfc;eO fb;' Ilm/ICf/~ f- :d> 975 Dff-K I:::-u~e:., 3Lj5'~ 3o/. THIS APPLICATION FORM MUST BE SIGNED BY THE OvillER OF THE PROPERTY TO BE INSPECT,ED. . .r~~ ~ tJcufk, . .. 1;..)'O'(.J1Q I:od i SIGNATURE OF ~ROPERTY m\TNER I .' FOR OFFICE USE ONLY - - - - - - - - - ~ - -:- ~ - - - - - - -- - - - - ~ - - -- ~ - - - - - - --YO 1i ~"O ~- - - - - - - - - -.- - - - - - - - - -- DATE OF INSPECTION: ,RECEIPT NUMBER: tD 3 ?9o DATE PAID: lil//3./d'-l fJd, . DATE OF REPORT: DATE. OF CERTIFICATE OF COHPLIANCE: COMMENTS: . ,. '," - ':: 'I".