HomeMy WebLinkAboutOccupancy Correspondence 1987-2-2 (2)
CITY OF SPRINGFIELO'"
Department of Planning and Dev~ment
. Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPEC~N
APPLICATION
C)o~ , i "1
/."
SPRINGFIELD
DATE: FF.-&f2.0M2-.. -z... I ~ B 1
JOB ADDRESS: I b <,;"S- 1\ I A:~-.A-o:::>.....!. ~ "'2> \..
OWNER: J>~t0~\~ e..E..~ D
mvNERS ADDRESS: ZB~o 1::>\2.'i C,ULC~, 3'p'<"'~c:;,~ LU T
APPLICANT: SPrL'I- ~ ~~c....\' (""7~'-1.&=F
APPLICANTS ADDRESS: loS? ~D\~S6'J (...Jo.J, SPf::lfJ(;(::tE.cD S,d, 7.7
,
0\,.
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER:
II'--^- \ '?-E.. E.. v (~
( z... c. - ~ s:- z.. '-,.
PROPOSED USE:~.~\1 ~ CAe.~ r-Ac..~U \"'\ - z.u C\-\ILD(<::\:::..~
A $ 35.00 INSPECTION FEE IS REQUIRED, AT THE TIME
OF APPLICATION '
THIS APPLICATION FORM MUST BE SIGNED BY THE OvlliER OF THE PROPERTY TO
BE INSPECTED.
~ee.. AI.)T~~e...\z.."\-\\o",< Will.\. <;\V-:-~( E,u-:J 4ft"1
SIGNATURE OF PROPERTY OHNER .--r.,"'II ~
-$UB"v.. I. \TI"-J:> i3'j' v,-\Jl...a.... c...~
---------------------_:~~-~:::~:_~~:_~~::_-~-~~~~-~-~~~~-~---
DATE OF INSPECTION:
RECEIPT NUMBER: IS //7?LJ'Lj
DATE PAID: ;< -;z - f?1
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: