HomeMy WebLinkAboutPermit Fire Damage Report 1991-1-21
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
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DATE: I - J.. I - q I
TO: 8uilding Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building 1('i;), I (")I'!-Q<;nrv 4t_
Name of o\'mer A Al h 114 \I. I-nv
Type of building
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(Dwellihg, Store, Warehouse, etc,)
Estimated value of building $
Estimated loss to building $
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Date of fire
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Location of damage in building /nrlf.lI'Cfr p(J/JJlj{J1/ {OIO U)f/A,
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(Roof, Wall, Exterior, Interior, etc,)
Structural weakness as a result of the fire "iQ
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(Burned rafters, Beams, Joists, etc,)
Additional pertinent information ~
Electrical Hazard ~
(Wiring, Outlets, etc,)
Signed ~);.;, f j/fl{1A~1____
cc: Pw
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