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HomeMy WebLinkAboutPermit Fire Damage Report 1986-12-30 ,; ,I,' ". . . '. :# ~wOq;?5 FD-16 FIRE DAMAGE REPORT OR ELECTRICAL HAZARD .DATE: /J... - 30 - 86 TO: Building Department FROt,1: Springfield Fire Department SUBJECT: Structural Damage to Building Address or location of building 43 L/.3 D/t;~ II Name of O\"mer ri1L~ ~j)< tJLJJ1.o. (.,~/~~i ~DR. Typeofbuilding ~i,~lf: ,'JH~\.;Il/ clWI!UiNl'. rF-Nl~' , ' (Dwe1~ing, Store,JWarehouse, etc.) Estimated value of building $ Estimated loss to building $ Lf :)',006 '-I . 000 , Da te of fi re J:J. - ~ 0 - 8"& Location of damage in building S.):. b~drrk."M /,))14- LI-"" ~ S.k- 'A-Na f ~i I; l-oc, o (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a result of the fire Mo II) E. (Burned rafters, Beams, Joists, etc.) Additional pertinent information l'r,,1J . t-{i WI rtF: " ~ 16c<'{ riCA; { Electrical Hazard _'JJfWJJ oJ h&~i.~.r () ~ E. .".,.d \^/l4-lf. (Wiring, Outlets, etc. ) Signed II. M ~nl\l' I ,~.Il~ cc: