HomeMy WebLinkAboutOccupancy Housing Code 1990-12-13
CITY OF SPRINGFIELD
Department of Planning and De*pment
Building Safety Divis '
225 North 5th Street
Springfield, Oregon 97477"
726-3753 (Bus,) 726-3769 (Insp,)
HOUSING INSPECTI4It
APPLICATION
DATE:
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JOB ADDRES S : . '(?: <;""" is r r<? nul' /~ f'.." tD,f)
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OWNERS ADDRESS:
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APPLICANT:
APPLICANTS ADDRESS: .' ''''';'<1 P e:::iJ' = t:"'H ~ .-v;p;).. _, .
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: /kMP t::Y1-/n'?
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIHE. OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE O~~lER OF THE PROPERTY TO BE
INSPECTED.
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
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RECEIPT NUHBER: -t ~q ~t:L
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DATE PAID: 17/-I{-Cf{)
COl1MENTS: