HomeMy WebLinkAboutPermit Fire Damage Report 2002-6-5
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TO:
Building Department
.:\ f")O'L330oD 3~016
FIRE DAMAGE REPORT
ELECTRlC~ HAZARD O~- OOl~-o'
Date: 6,.- S - CJ 2-
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
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(Roof, Wall, Exterior, Interior, etc.) .
Structural weakness as a result of the fire V e"5: /~-7S J .-)'/17'>& / bI ,r.i?-f
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Address or location of building
Name of Owner
Type of Building
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Estimated value of building $
Estimated loss to building $
Date of fire
Location of damage to building
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(Dwelling, Store, Warehouse, etc.)
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(Burned rafters, Beams, Joists, etc.)
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(Wiring, Outlets, etc.)
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. Additional pertinent infor~ation
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Electrical Hazard' V R.5
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V:\FDJORMS\FD-016 FIRE DAMAGE REPORT.doc
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