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HomeMy WebLinkAboutPermit Fire Damage Report 1995-10-10 -=:- . . ~ ~\ ~l~ FD-16 srers <l25, FIRE DAMAGE REPORT OR ELECTRICAL HAL~RD DATE: (O!O<5ICf\ " ' if TO: Bu i 1 ding Depa rtrnent " FRO~1: Springfield Fire Department .SUBJECT: Structural Damage to Building Address or 1 ocati on of bU,il ding Name of O\'mer C:nv'1 T2-e<t.J I :Type of building o-C--kr.:L ~'iJll,~\'/)'1 ( Dwell illg , "ior 0 , C.:.> ,,-., t>'l.e.;-Cc, l ----:> <.- '> ~jy ~~CF~ frl{MJl Warehouse, etc.) Store, . Estimated value of building $ ,Estimated loss to building $ Date of fire l () I (?':5 1'1 c:;- Location of damage in building ~ f'o,(/.n', , ( Rc.4.;- s,fc\ ...~ !.o/" .. . l2..cz<1.r de} <.V rt '> h:u'i'\' t, '" It I rA,H-cI-{ {,'vv,( ,-CLVdr l( ~<; ~...,.., I;,i'l' '2. ".J-HeJ-~- '--b {'-e-'lf- ,g{ !:>v; Ic,'V~, (Roof, Wall, Exteriof, Interior, etc.) .~ ~,~....- ,5vrAeJ r~f~-Kr<; , (Burned rafters, 5<'iKJ' ~ ~'1 d. 4 V~~...) ~,"2..,A 'S;~ '7 +I'i Structural weakness as a result of the fire B 1 . .. eams, ,-,01 S :..S , etc. ) Additional pertinent information . Electrical 'Hazard, Ove/~4'~ Ilj/..,'h b.,J~~...{ r ,./il'i:) ,ried'f'OlCLA., ~W,,'.tz,.lr-S {CAr VH~' ,c{,?ir"laj""~ vir-i'j C{l<;.;." (Wlrlng, Outlets, etc.) " D'.I cc: '/ Lv (ly{ () 10- iO- Cf5 Signed~lIl ;t~l f . \./ ,lJ1.c..(J-vLtJ.f