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HomeMy WebLinkAboutOccupancy Correspondence 1987-2-2 CITY OF SPRINGFIEL. Department of Planning and De pment Building Safeti Division 225 North 5th Street Springfield, Oregon 97477 726-3753 (Bus.) 726-3769 (Insp.) OCCUPANCY INSPE~ON APPLICATION "To\.{, I .11 SPRINGFIELD / (j ") '11 v( DATE : ,1,eJ:r",a;~;1, / 9 i 7 JOB ADDRESS: 10 '/0 ~ ~tt..d- OWNER: ~~ ~A-U..u ~ C/Gl ~ ,~JUA-UHA.I~..1. ~ tJ . .. .....m.,7~'J (/ / mvNERS ADDRESS: M/ E //l!! . Gu~. l'tL t:1,f.JO/ (J p C(;1V 0 15" APPLICANT: \l1 a.~ c.- ;. APPLICANTS ADDRESS: FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER:~ ~ ~~. ~ ,~. N.,. ~J'"7-/ct~c.L , PROPOSED USE: MtlMj<- ~~ -h ~ A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION . THIS APPLICATION FORM MUST BE SIGNED BY THE OvfflER OF THE PROPERTY TO BE INSPECTED. ~ FOR OFFICE USE DATE OF INSPECTION: RECEIPT NUMBER: 8/0 J113 . DATE PAID: ;}-;;2 - ~ /) DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: