HomeMy WebLinkAboutOccupancy Correspondence 1989-6-5 (2)
CITY OF SPRINGFIEI~
Department of Planning and D~opment
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
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OCCUPANCY INSPECTION
APPLICATION
DATE: &,/~/ reo;
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JOB ADDRESS: 601-
OWNER: ''Prj.e r 'l.
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mVNERS ADDRESS: :27 '!>blh . L-r h 1..0 I., d.
APPLICANT: 5t,erhJ~ Beyc.,,--
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APPLICANTS ADDRESS: (If 0 ,,1) sJn::e./ ~/l:/Y'''1.lrolcl O~
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 6,f"{, -u. 6C:---
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PROPOSED USE: 5 rn evil coft e. S't.olP 4.~ ..ek.u'J ?Jal-U!- f.... ~""i;
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A $ 35.00 INSPECTION FEE IS REQUIRED. AT THE TIME
OF APPLICATION
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THIS APPLICATION FORM MUST BE SIGNED BY THE O,mER OF THE PROPERTY TO
BE INSPECTED.
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SIGNATURE OP/PROP~TY OIVNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION: RECEIPT NUMBER: IW tfV-
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DATE PAID:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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