HomeMy WebLinkAboutPermit Fire Damage Report 1986-6-3
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
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TO:
FROM:
Building Department
springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building _ 48d~ J-I,fihbtJP 1:~('.Pd
Name of o~mer
Type of building
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(Dwelling, Store, Warehouse, etc.)
Estimated value of building $ S-O, ~
Estimated losS to building $ 3s . e-a-o
Date of fire
location of' damage in building' --J.-/trQC:-'. <;j.. ~
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(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire /Ju/Vtud! ralt:.<S
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J (surnedrafterS, Beams, Joists, etc.) /.
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.~dditional pertinent information
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El ectri ca 1 Hazard toN i/?( ;11 {}/t.R CL.-
(Wiring, Outl ets, etc. )
Signed ({ /t;, 7vJ/!-~/f 'tV<
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