HomeMy WebLinkAboutPermit Fire Damage Report 1992-10-8
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SPRI~GFIE~) FIRE DEPARTMENT ~ ~
FIRE DM1~GE REPORT
OR
ELECTRICAL HAZARD
DATE: /0- 8'7,).
FROt.1:
SUBJECt:
Building Department
Springfield Fire Department
TO:
Structural Damage to Building
Address or location of building
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Name of O\'mer L-J (" y /1i .,:. NA-c.f
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Type of buildi ng .J (' .
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(D~'ell i ng, Store, HarE~house , etc, )
Estimated value of building S
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Estimated loss to building 5
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Date of fire
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Location of damage in building
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~ (Roof, viall, Exterior, Interior, etc.)
Structural weakness as a result of the fire
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(Burned rafters, Beams, Joists, etc,)
Additional pertinent information
Electrical Hazard
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(Hirina, Outlets, etc.)
Si~ned
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