HomeMy WebLinkAboutOccupancy Housing Code 1983-2-4
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HOUSING INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
DATE:
2-4-83
JOB ADDRESS: 2384DDornoch St. Sorinafield. Or_
NUMBER OF UNITS: - i
OWNER: Secretary of Housing & Urban Development
OWNERS ADDRESS:
520 S. W. Sixth Avenue
Portland, Or. 97204
APPLICANT:
a5*a~~e STATE Realty A.M.B./HUD
APPLICANTS ADDRESS:
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143 Madison Eugene, Or. 97402
FOR ACCESS TO PROPERTY - PLEASE INCLUDE TELEPHONE NUMBER:
686-1971
HUD Lock Box
A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
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INSPECTED. '....
SI~~
, PROPERTY OWNER
-D} W. Haase, A.M.B./HUD
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
DATE OF CERT. OF COMPLIANCE:
RECEIPT NUMBER:
DATE OF REPORT:
REMARKS:
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