HomeMy WebLinkAboutOccupancy Correspondence 1988-8-22
CITY OF SPRINGFIELD
Depa r:ment of PI ann i ng and Devil.Ppment
Building Safety Divis~
225 North 5th Street
Springfield. Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPEe?N
APPLICATION
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DATE: JJ~("Jw.57 d2. /7rY
JOB ADDRESS/ S';l5f '7 J ,~/ j:../tG f/J#KS
OWNER: 7 It. e.~1- :...J . ~ s S ;
m-lNERS ADDRESS: 5,q 44 e-.
I ied~ T. 1:2 D S; S i
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APPLICANT:
APPLICANTS ADDRESS:
:s.A- /VI €--
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 7 ~ ~ s-~ J /
PROPOSED USE:
t+ 1) /k t?"
A $ 35.00 INSPECTION FEE IS REQUIRED AT T}lli TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OlrnER OF THE PROPERTY TO
BE INSPECTED,
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SIGNATUP~6F/PROPERTY OI-lNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
RECEIPT NUMBER:
/;2/ & '3
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DATE OF REPORT:
DATE PAID:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: