HomeMy WebLinkAboutPermit Fire Damage Report 2000-2-21
.
10b :tt::- ~D - ~D') - (] I
FD-16
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: .2 -) 1- 60
TO: Building Department
Address or location of building
2/33
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Buil di ng
-
-? I ~ ~
L (t.-<- '-- ''L
Ncme of OI'mer -.:'S '~.c ic. C _ \~t') ( :\ t-fh/'
Type of building 1u>t. Ii ,"'\.'-,
(Dwell i ng, 'Store, \'Iarehouse, etc.)
Esti~ated value of building S
q('; O()0
!
Estimated loss to building $
Ui" r'...,
I v~ L.{jU
.' Date Gf fire
:J. - ). / - O('o
Location of damage in building
;2 ,~
.,..
.t.-cr.
I.U )1-./ i 5
c...e; 11'i~ joist
(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire A/.,.02~J /"'\:.I.f-klS
jUt S f J
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard
a/i (.u,rr',l!;
,
cviJ'sla ir)
I
(Wiring, Outlets, etc.)
Signed
C0A'
"7
J ;)Ui.A...-< '
,
cc: