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HomeMy WebLinkAboutPermit Fire Damage Report 1989-1-12 , v -. - FIRE DAMAGE REPORT OR ELECTRICAL HAZARD ::f=F ?f/MJ ~ 5' DA TE : I - I z... -~ '( TO: Building Department Vjl.i() I" \ \.\).. FROM:' Springfield Fire Department Address or location of building Name of OI.mer jltt. fJitJi' Chdo 4- Ha..vlo uJ jJ Jt-?U'EI/~ r C.o_Y (c;..a......--a... 9-~ (Dwelling, Store, War~ou5e, etc.) ~"> fA'" . SUBJECT: Structural Damage to Building ?ISO I~!?w 7 ;:'/1>'/ 9fb~ .Type of building Estimated value of building $ 3<0, 000 I Estimated loss to building, $ ?c:;-,OOO I Da te of fi re 1 - I 2- - J? 7 Location of damage in building. vJed Is ): roC! r::- I (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a resul t of the fire wa...1I s ](Jl'S 13 r3'-'r"'<.d +1--~t','-<.L - '("vcl! c..cil,zp>-<...- (Burned ra f t~rs, Beams) Jo i s ts, etc.) I E I (80~ I Additional pertinent information o.J( , , WI.....' tv,,! (Wiring, Out~ts, If cOu+/e'l<;. c Fr= e c... + C"-cL etc. ) LU e. v- e. Electrical Hazard Prese.-vT. \..Jvv 1'---(\)0 lurv Signed k:v c' 'r7. }/!:;-L: cffT~ 'A".s-~ .2~ ~ / cc: