HomeMy WebLinkAboutPermit Fire Damage Report 1990-1-6
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: 1- II - q'O
TO : Bu i 1 ding Depa rtmen t
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building 77Jli t:)f~Uj-t.I/d
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'J (Dwell i n9,J Store, Hat4house,
Name of o~tner
Type of building
etc. )
Estimated value of building S I IOj nOn
Estimated loss to building S 2,1It) 1)
. Da te of fi re
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Location of damage in building _Lru,"j
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(~cof, Wall, Exterior,
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Interior, etc.)
Structural weakness as a result of the fire
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(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard IJ.,IY\"
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(Wiring, Outlets, etc.)
Signed 01/\ uf /2;~,1d..t;,;.
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