HomeMy WebLinkAboutOccupancy Housing Code 1990-1-31
~
CITY OF SPRINGFIELD
Department of Planning and D.pment
Building Safety Divi
225 N~rth 5th Street
Springfield, Oregon 97477
726-3753 (Bus,) 726-3769 (Insp.)
HOUSING INSPECTtIII.
APPLICATION
Cl r~YI .5 <6
SPRINGFIELD
~
DATE: '~:SGnLA(l(\/ '3119g0
JOB A~DRESS: ~S1 (~\uetr.l~\'\l t?d.J So-\cl. n~
OWNER: Sv('r.,'"( K ( ~p I J
OWNERS AD~ESS: ~o.S~ktl V,e\A/ I nilt" _ &>tct CAe
t Ii 1- ~ I J
APPLICANT: ri(=r(o-8~ D. NOJt::~3 ~"'GE-('\lS.. Mc.l~elJ ~('('..C(""R
APPLICANTS ADDRESS: ~LjOS R->.\C'l.../ U'eL.-) \ nct.t'. S."J!d. 'he
/ ~ 'f'C J (
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: ~~(,-~~ lF1~
J'r.ll ~ h~<:. l?--i~- -/-'" ;\:-t~~('tlo\ ~'-7 ("'ltr-rlf'J ~ e.nc..We.. u" f.-() ci.ve.
i(b"tit~, 'to \k\1.~~ 1 \J .
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIHE OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED.
~....--::-. .--::
1 ..; ~
S~ PRm,ERTY OWNER /'
FOR OFFICE USE ONLY
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COHMENTS:
RECEIPT NUHBER: \ '0CJ ~ 8"
DATE PAID: /;)...)...q()
-
~