HomeMy WebLinkAboutPermit Fire Damage Report 2002-6-20
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: (~/20(OZ
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of owner . 'j nOW\ (:(,...'t:>Ma",
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Type of building
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Estimated value of building $
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Estimated loss to building $
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Date of fire
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Location of damage in building
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(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire 'Sfud;" ,.!n'l-C.-,.[rClV'"1;J
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard
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(Wiring, Outlets, etc.)
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