HomeMy WebLinkAboutPermit Fire Damage Report 2001-11-6
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: //-00-0
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building _ .3.2 S"S- GJ4-/~t.<.>>: Aof J/ J 31.
Name of owner G~fec.....>:L( U;Ll~~ Ll.o+-s
Type of building ;fJ..1J;u/1NU/
. (Dwelling, Store, Warehouse, etc.)
Estimated value of building $
Estimated loss to bUilding $
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Date of fire
;(-~ - 01
Location of damage in building
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(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a resul t of the fire ~,
(Burned rafters, Beams, Joists, etc. i
Additional pertinent information
Electrical Hazard 4Hr/I'I'j h Slvk A.... d~r,.e.o(...
(Wiring, Outlets, etc.)
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Signed (A'A~'-c-" /,~
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