HomeMy WebLinkAboutPermit Fire Damage Report 2001-3-16
: CITY OF SPRIN.LD
, Fire & Life Safety
.-
r oj;' OO'd-7r ();f-lb
/f{))- 0). ;l. 3 04'ic5v
O/---03sL/ofo
,FIRE DAMJl.GE REPORT.
OR
ELECTRICAL HAZARD
DATE: '":? - /~-6 (
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building ,c,t!?€1'7 C/-AP"_~
Name of owner La.\/'.o u ..../~ ,&A"",p S
;;
Type of building $';;" L. F~.7.L, //u'o<J/Jo.Au
o (Dwelling, Store, Warenouse, etc.)
Estimated value of building $ / 8'Q" bC-~. ~
Estimated loss to building $ -::;; 5: o-e.<:..'" ""-
Date of fire ~ - I" G-c (
Location of damage in building ,k;-,jpiJ:..r.,..: N'6 s-i.,._./,'........ O~
&':~~~! '<'~~;...-{;ro;, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire
r-/~ ~
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard, LeJ/r:'-" ,'-".L .+-/,-./.-""-.'-- -Or....""'- 6<-........J~..{,
r
(Wirinq, Outlets, etc.)
cc:'r [A)
Signed ~.~_~'" ,~~
j- 21-0i I't