HomeMy WebLinkAboutOccupancy Correspondence 1987-8-26
-
CITY OF SPRINGFIELD
Department of Planning and Dev~pment
Building Safety Divis~
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPE~N
APPLICATION
SPRINGFIELD
DATE: ? l~t., /5? 7 $11Ub;)b
JOB Ao;dJr: 3- {;Ij] ~h1-Y;Sr ;>>;J,e; /\J <; -I'i p / ~ C) rP '? ? vn
OWNER: /k --I ~(' c A 77e0 / P U //[/f
moJNERS ADDRESS: 5(') M111/ 9'9 N, A./c?e-/IN~ /fJf? "
APPLICANT: /f// nit / j? A ) ~ / / ' / /
. /. - - -- -='
APPLICANTS ADDRESS:37'S--</ GfiT-P W/l-I/ .5'7 s//?Uvt<!=Af?/c! !tRy/c?>
I ' /
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER:/7<'?-O '8'""3 c:z
,.
PROPOSED USE: (0/0 u e f\.J/ 'fJ /J C (0 "Oroi2 e ..( (' A /V (/ e vs; iJ N )
A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION -
THIS APPLICATION FORM MUST BE SIGNED BY THE OvrnER OF THE PROPERTY TO
BE INSPECTED, // .-.4-
~A'gz~:. ~~.-
~ATURE OF PROPERTY m-mER ./
FOR OFFICE USE ONLY
---------------------------------------------------------------------------
DATE OF INSPECTION:
RECEIPT NUMBER:
/J-ofb
~'/210-??
DATE OF REPORT:
DATE PAID:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
t1ol.of, 11/ I
tAl
~?-
V