Loading...
HomeMy WebLinkAboutPermit Fire Damage Report 1992-1-30 " [2, t I:..~ ~,1,., h-,-, :j()b ~WOq 9 FIRE DAM~GE REPORT OR ELECTRICAL HAZARD DATE C)1-~O-q2 TO Bu 11 d 1 ng Deoa rtmen t FROM Spr1ngfleld Flre Department SUBJECT Structural Damage to BU1lo1ng Address or locat1on of bU1ld1ng 11'60 (t"",{,.lI1iA,AI 'R(uJ Name of o~mer N;vtLlAJ" I ~tbe.,A..o Tyoe of bUlld1ng ~e-\-",~\ ~tvP - Loija b~(}V 4. (..6'&-1" (Dwell1ng, Store, Harehouse, etc ) Estll'1ated value of bU1ld1ng 5 r:;rut)O I Est1mated loss to bU1ld1ng $ I (), (\00 ('; ( -~(\ - q '? \MA~",,\ Da te of f 1 re Locat1t4 of damage 1n bU1ld1ng laA+eY\i\v IllJJ" I (p \\;~'\ "( 0 0'4; '(Roof, Wall, Exterlor, Interlor, etc ) nul Structural weakness as a result of the flre hl'lt, <. ;\1\ I(CO~ (3urrea r37:ers, 3ecms, \2,tJ.N v\ .. ~ \"'ipa,,'vt<:. - '-'01 5 ~S, e tc ) \"'",,\ZP!.A. - ~D-A~ Wdw 1-W1lAfr\ ~ ~~\t\f< Q \OVI-Q (;c \;V\P ~.(1/ ) u ~t.,^,-,,\ .Acdltional oertlnent ~nforii1a~-on Electrlcal Hazard --L..fn<.."~ .. 1,J\ IfP nuHJ (1T1 H'U<:' IMt (~rL (W1r1nq, Outlets, etc ) Slan~~~\~~~t ~(( \ cc D ,\ , I..v I '3 I Lf 2 C-.:}"