HomeMy WebLinkAboutOccupancy Correspondence 1996-5-30
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(541) 726.3753
FAX (541) 726.3689
OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: )~ .:3(;> ~ 910 JOB NUMBER:
ADDRESS OF INSPECTION: LI'>(" 3 Leu ..Q.",
OI/NER: /lL..Lc.e L"IA)RT'1J;WT2.L6.Hr
OIlNER'S ADDRESS: laJoD I~S=:L Lau.r.:
PHONE NUMBER: 7 l.f" . '9 z. '5"8
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APPLICANT: (!., ~A) A &aen.~ / '7) 8A l rpn.n-r€~ -5~
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APPLICANT'S ADDRESS: ~I 'S~~tI ~rnc~ tJ1'E.'';' t)Plbd.FJt:I-'1> tJI2. <7)'11fJ
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: 7'1 '1- Y 5"'7 3
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PROPOSED USE: OPBZA"ff. A 0 -1-4AvL 2t;;AJ7#l~ ~EiAl-GJ'L-5U-JP fl/lfll
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A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OIlNER OF THE PROPERTY TO BE
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SIGNATURE OF PRO~TY OWNER ~
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FOR OFFICE USE ONLY
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DATE PAID:
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DATE OF INSPECTION:
DATE OF CERTiFICATE OF COMPLIANCE:
COMMENTS:
PROPOSED FLOOR PLAN REQUIRED AT TIME OF APPLICATION