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HomeMy WebLinkAboutPermit Fire Damage Report 1982-2-1 1\. ~ .,. ..' ~ \ . \ ~~oOql. FD-16 \ f(fC rlllc "I( INS" fCrOIl ,I . FIRE DAMAGE REPORT OR ELECTRICAL HAZARD 1r8Ji~Ii:l(~lnl Jl t-.z-8'-.lYJ DATE': f.d, I Irf l- I I TO: FROM: Building Department Springfield Fire Department 17-03-3~- 31 0916-0 SUBJECT: Structur.a1 Damage to Building Address or location of building t.; ,~o 'Jn~u"~ 51, Name of owner _~'^"fL-' Ih- Co ~~Q ~ Type of building 'c:.il>-\L.J (Dwelling. Store. Warehouse. etc.) . Estimated value of building $ Estimated loss to building $ Date of fire 2 - I - ~ L Location of damage in building 'V1~ ~----~~ (Roof. Wall. Exterior. Interior. etc.) Structural weakness as a result of the fire -4~ -M.~ - ~ ~' U (Burned raf}ers. Beams. Joists. etc.) Additional pertinent information Electrical Hazard L.j- ~ o (Wiring. Outlets. etc.) ~\ Signed ~f f)~(J 7'7. ~;L, tf' , cc: !