HomeMy WebLinkAboutOccupancy Correspondence 1988-8-22 (2)
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,,2~"" (lTY OF SPRINGFIELD ------,
::iJepar::::ent of Planning and DevAoment
i Building Safety Divis~'
,
i 225 North 5th Street
: Springfield, Oregon 97477
! 726-3753 (Bus.) 726-3769 (Insp.)
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r OCC1:lI'Jd INSPE!Yoc;
APPLICATIOK
SPRINGFIELD _ .
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lb, ry'oor c
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JOB ADDRESS: S;;Z X '7 ) /h L) ~-4 H' K""S 12 rI
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OHNER: U e.'; 1- --.J. r::::.. ~ s" /
DATE:
OHNERS ADDRESS:
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APPLICANT: / ;be .//f T. 1=2 D S' S i
APPLICANTS ADDRESS: $.4/1/1 €_
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 7_7 t:: _S-~ J /
PROPOSED USE:
-H b ,/11 f"'
A $ 35.00 INSPECTION FEE IS REQUIRED AT T}~ TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OlmER OF THE PROPERTY TO
BE INSPECTED,
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SIGNATUP~6F/PROPERTY O,VNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
RECEIPT NUMBER:
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DATE OF REPORT:
DATE PAID:
DATE OF CERTIFICATE OF C0l1PLIANCE:
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COMMENTS: