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HomeMy WebLinkAboutOccupancy Application 1997-3-24 OCCUPANCY INSPECTION APPLICATION 225 FIFT/-I STFlEET SPRINGFIELD, on 97477 , (541) 726-3753 FAX (541) 726-3689 CITY OF SPRINGFIELD BUILDING DIVISION ================================================================================ DATE: t-\&~\.... :l4) \OQ, JOB NUMBER: q~,Yf0 ADDRESS OF INSPECTION: 56&" W~-\- (~iV-teAJI\.h'a.J B\VJ.. o lJNER : -C. oe2lV-t -.2. IV I\) \;C~.l C e."I'\'-ev'- a.~c:r... OWNER'S ADDRESS: PHONE NUMBER: ,-~4.\ - ~~ -4l\.~ APPLICANT: 'T. \J.L i w~ l') P, P. ~CUJ ot2.r-~ / 11 eU.lL>lL () l \ \aa Q I ~ APPLICANT'S ADDRESS: 1\ 1..\Ol"\ s..e (,.., -\:11-- ~e \\ -eUUQ I U la... G( <rlCXJt.-{ FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: =========================================================================~====== PROPOSED USE: R e... --\a , \ " A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OlJNER OF THE PROPERTY TO BE INSPECTED. }:\~ cJ.~J?~ ?kAIo,j)i AM~ SIGNATUR~ OF\PROPERTY OWNER -~-- \ ~ -------------------------------------------------------------------------------- FOR OFFICE USE ONLY -------------------------------------------------------------------------------- DATE PAID: 9....2.&"-57 RECEIPT NUMBER: :2. S'o ~2 ,DATE OF REPORT: DATE OF INSPECTION: DATE OF CERTiFICATE OF COMPLIANCE: COMMENTS: , ! PROPOSED FLOOR, PLAN REQUIRED AT TIME' OF APPLICATION A .".. :.;,:. . I ~ 20,988 son, ~ fl , ! i ~J D \--- I~ ---. J~ I , D 1~,4 I I:::: oooon I/C:::! I I I {X}------- - RETAIL I o o , 0 , --, [ ~ r o I LtJJ LtJJ lLJJ I 0 ~ lW_O" I) I SPRINGFIELD OR, 5,465 so FT BACKROOM_ x 560 so FT, ELEC, ROOM ,.,,---, o , " .~ ,I I I ,~