HomeMy WebLinkAboutPermit Fire Damage Report 1999-9-19
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FIRE DAMAGE REPORT
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ELECTRICAL HAZARD
DATE: ~ - l't - "r ('/
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of owner
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(Dwelling, Store, Warehouse,
etc. )
Type of building
Estimated value of building $ ?- Sc: DeD
Estimated loss to buildi ng $ 7 j )' Oc;
Date of fii"e Cf -lq .qt(
Location of damage in building'
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(Roof, Wall, Exterior, Interior, etc.)
Structural'weakness as a result of the fire
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(Burned rafters, Beams, Joists, etc.)
Additi ona 1 pe;'ti nent i nforma tion
Electrical Hazard <2.",- .oo::'c?,,-
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(Wiring, Outlets, etc.)
Signed
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