HomeMy WebLinkAboutPermit Fire Damage Report 2002-4-5
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: Jdf5,12.J-
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building!J:<'i:?
Name of o\'mer \/ / lJ ; l ~ e i'Y1 a V V'"
Type of buildi ng _129J eL\.'u~1 (flJ.JJM.I1~~ .f11i";(,/ ~\L)
(DWelling, Store, Warehouse, etc.)
Estimated value of building. $ C()n, 00"
Estimated loss to building $ It> -'~D. nno
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Location of damage in building Li\~rm~k,+c~
rel(,'AA~ I ~loc:v.
(Roof, Wall, Exterio~, Interior, etc.)
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Date of fire
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Structural weakness as a result of the fire
Bl.~ict.,l.Rr) f^'-'.L~f") I('" .Slil.f'R+.A..rC/,
(Burned raftert, Beams, Joists, etc.)
Additional pertinent information,
Electrical Hazard 2"?~~,p- ()u.+lJ-. d.D1Ml'^-~'f'
Signed
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