HomeMy WebLinkAboutPermit Fire Damage Report 1984-4-19
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FD-16
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: tJ-'/<-I-S!
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building ,:;;),:)7 b/lfft<.YlY p,or<P=-{;;
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Name of ~ L?8o$-/t);f r-../f/7AJ I-C '
Type of building '()VJ}[j=;V 2.. $7CJ,,(:Y /Jp/'/
(Dwelling, Store, Warehouse, etc.)
Estimated value of building $ ~
Estimated loss to building S ~
Ikn'/oc/3 1/ . f
Date of fire 1;"';TCI/r:.AJ ,H/9/1J6- LH.-r,P /JRC!..CO 0;) Cl/~/IU
Loc~tion of damage in building t.J?A./D~I'f'D Pf< ;LfA-N/-J6€P. 1t(jj~r5])
UJI/,?GS 7D6Erf/a<.... 17/lr'E.o -(..Ji.;1-JC-7/",o:5 ))"7 IAJ kx:)
(Reof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information ktJ6 /A.) 1J"u ~UTN tUI9Lv of
L-/U/,(){.- /COo/-! ,tM.s- d"AJ b tJF /,t./E SIDe.- i3J9R..:5 I3RtlKE;tI
~/tl/}k'IIy;. I/tVE-J(ffU:' l5e "TilE tf)(JTtEr / 'vtJP&1<f}f}C-;;-: CL-.4/Hc;D
IT /J/fc!-Ff) NII&/U <:'f/6 #'lTrz;HPTCb /"0 PL-/J6 0<..1 !-/P/Jr/;()G /#.0 ,
lectrical Hazard
1Ud%,':J ;t?C-,;;J ;'L(.5. k/<: I9A..rr-r= 70 C.JfU"TPI-<LT' Y;u e (JvCE-R~)I.o& -rl-/r S" , .
(~/irinCl' Outlets, etc.)
cc:
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Signed ,~/J ..lJ-./.f~ .