HomeMy WebLinkAboutOccupancy Correspondence 1984-7-13
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CITY OF SPRINGFIE,a .
Department of Public~ks
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus,) 726-3769 (Insp.)
OCCUPANCY INSP"'ION
APPLICATION
DATE: 7 - / 3 - ~~
JOB ADDRESS: 3/,5-? G!A7e' !.dAY
OWNER: .JAALIIII Pnap'/2'~"'J~r'-
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mVNERS ADDRESS :-:YO 3 ~ Nc _ f),ehh.:LA;,,,' I?c,::uf:n_nr., ~ 7~'N:P
APPLICANT: J L'.) .-- a ~ ~ L/ III 2-
APPLICANTS ADDRESS: 37.3~~ ~J12.1d..v/!. (!/?/f"-RI:JSPI?/A.F~P~~l:>
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 7#'t.~ 9' 5".3
PROPOSED USE: 1)IP" t..L ~A"JeA..J
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A $30.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION '
THIS APPLICATION FORM MUST BE SIGNED BY THE OvlliER OF THE PROPERTY TO
BE INSPECTED.
SIGNATUP~ OF PROPERTY O~VNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
RECEIPT NUMBER: K G 321,(,
DATE PAID: ') . 13 - g-t/
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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