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
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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/
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p
C(;1V 0 15"
APPLICANT:
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APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER:~ ~
~~. ~ ,~. N.,. ~J'"7-/ct~c.L
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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.
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FOR OFFICE USE
DATE OF INSPECTION:
RECEIPT NUMBER: 8/0 J113 .
DATE PAID: ;}-;;2 - ~ /)
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: