HomeMy WebLinkAboutOccupancy Housing Code 1988-7-22
CITY OF SPRINGFIELD
Department. of Planning an~v&ment
Building Safety D~Sl~
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
HOUSING INSP!"IdIIt
APPLICATI N
SPRINGFIELD
DATE: '1/Z -Z/ ef t
JOB ADDRESS: 1:J." '1
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OHNER:
OWNERS ADDRESS:
APPLICANT: Il\" r +-: h. .{... fV\", {'- (0.... S VlI\ ; -f "'-
APPLICANTS ADDRESS: 2/ f? r Deb 1"Cl... . S P f' " hI-+: \ ~ JJ...,
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FOR ACCESS
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TO PROPERTY--PLEASE
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INCLUDE TELEPHONE NUMBER:
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIHE OF
APPLICATION
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THIS APPLICATION FORM }ruST BE SIGNED BY THE O~~ER OF THE PROPERTY TO BE
INSPECTED.
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SIGNATURE OF PROPERTY OWNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
RECEIPT NUHBER: (Z.OO.q
DATE PAID: g 'I-~~
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COl1HENTS :
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