HomeMy WebLinkAboutOccupancy Housing Code 1991-2-22
CITY OF SPRINGFIELD
Department of Planning_and. ~e.ment
Building Safety Div~ .
225 North 5th Street
Springfield, Oregon 97477-
726-3753 (Bus.) 726-3769 (Insp.)
HOUSING INSPE~~
APPLICATION
DATE: ;::-.e\? 7.--2- . I q q r
JOB ADDRESS: '2-:5 Z Lj- t-\-Cu-+ V\.^-(.\J/\
.-;-
Ol.JNER: M a VI SDV1 ~ fA (lk-. SOVl
OWNERS ADDRES S: 2- 7 0 3'1 i2-D l/) C\...I
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APPLICANT: M t<..Vt StxVJ IJ 0\. e-lt-SVV7
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Au Q.. E: f).A en-e
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APPLICANTS ADDRESS: ITl.W\ ~v
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: &~ <;[ -153 &-
PiLUM..- CoJ.J.. as ~1fls-t --V 8~6bGlt'V\ Cl5DI)S~; (ole.- - V1?\ /4.:t--ev #1M 8'~?rl
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIHE OF
APPLICATION
THIS APPLICATION FORM HUST BE SIGNED BY THE O~~ER OF THE PROPERTY TO BE
INSPECTED.
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SIGNATURE OF PROPERTY OWNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
d' QB-Cf I
RECEIPT NUHBER: I q 3 Z-.7..--
DATE PAID: Z-2-2-crl
DATE OF REPORT:
DATE OF CERTIFICATE OF COHPLIANCE:
COHMENTS: