HomeMy WebLinkAboutPermit Fire Damage Report 1985-4-26
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: C).(,(.\.p~\.~~-
TO: Building .Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
Name of owner fI SSe> c.;:,~
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Type of building ~~
(Dwelling, Store, Harehouse. etc.)
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Estimated value of building $ ri-oo()-
Estimated loss to building $ l'~
Date of fire
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Location of damage in building "\ 0"\-0..)
'(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire
(Burned rafters, Beams, Joists, etc.)
Additional oertinent informa ticn
Electrical Hazard
(Wiring, Outlets, etc.)
Signed
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