HomeMy WebLinkAboutPermit Fire Damage Report 2003-4-3
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
TO:
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Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of owner
Type of building
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, !(DweVfng, Store, 'Harehouse,etc.)
Estimated value of building $
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Estimated loss to building $
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Date of fire
L(-3-03
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.)
Additional pertinent information
Electrical Hazard
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(Wir1ng, Outlets, ~c.)
Signed
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