HomeMy WebLinkAboutPermit Fire Damage Report 2000-2-21
FD-16
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: .2-)/-00
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of owner
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(Dwell i ng, 'Store,
Ha rehouse, etc.)
Type of building
Esti~ated value of building $
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Estimated loss to building $
Date of fire
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Location of damage in building l2:!cF. /.'-"/1-/15. C-ei II')'~ loiSi'
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(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire fll.L'-I2L':( 1""1'.( 4?-.,.5
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(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard
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(Wiring, Outlets, etc.)
Signed
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