HomeMy WebLinkAboutPermit Fire Department Referral 1984-12-20
'\ SPRINGFIELD FIRE DEPARTMENT
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r ~ h 2(j 09 s S- INSPECTION REFERRAL FORM .,
TO: Ele~cal Inspector 'y Date of Referral
Plumbing Inspector
Building Inspector
Mechanical Inspector
FD-166/83
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Address 33S"'o 6-I4-~Wl/!,.o.(
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Environmental Inspector
EXPLANATION OF REFERRAL
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ACTION TAKEN (Attach copy of orders)
By
Date
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OCCUPANCYNAM~6dNflG.R~ J.AS,?lIr
AOORE$S 33S-o (J,/J-kwA4 BUS. PHONE 7,;,6 /~ I
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OCCUP.NAME . L..b/1/ L:e-G CC1~I'. HOME PH.
BUILDING OWNER ,Sf, /~ IN<!... PHONE S'-~<f S;~(,s;
FIRE DEPARTMENT INSPECTION
ADDRESS
I CODE SECT~N I
VIOLATIONS
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YOU ARE HEREBY NOTIFIED TO CORRECT THE ABOVE VIOLATIONS WITHIN
DAYS,
SIGNED:
INSPECTORA0v~ n~:; 'Jl!A CO. /1- I
VIOLATIONS: Noted
DATE 1J.--I'f-fcI ABATED
NUMBER