HomeMy WebLinkAboutPermit Fire Damage Report 1994-11-8
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CITY OF SPRINGFIELD
Fire & Life Safety
Sf- q ~ - 3'22,"
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: JJ- g-qL.(
TO:
FROM:
Building Department
Springfield Fire Department
SUBJECT:
Structura 1 Damaoe to Bui 1 di no
. - .
.liddress or location of building ]/;b I~ &,
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Name of O\.merrf) ~ 0 ~ ~
Type of building I t,~ ~'^ff
( (Dw6'! 1 i ng. Store. I~ar~ouse. etc.)
Estimated value of building $ qs-;OOO
Estimated loss to buildi ng $ :J-o () 0 ()
Date of fire ~ - ) (- q <f
Location of damage in building ~~
I
~
(Roof, Wall, Exterior. Interior. etc,)
Structural weakness as a result of the fire
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r ' (Burned rafters. Beams. ,loists. etc.)
Additional pertinent information
Electrical Hazard -:u~ ~ Vr- ~
(,Iirinq. Outlets. etc.)
Signed;j2QA/yt.O ~
cc: ""1'7 (JJ
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