HomeMy WebLinkAboutOccupancy Correspondence 1985-12-24
~.,- '-~-7ITY OF SPRINGFIELD.
: Department of Planning and Dev ent
Building Safety Divisi
225 North 5th Street
I: Springfield, Oregon 97477
I [726-3753 (Bus.) 726-3769 (Insp.)
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JOB AD~RESS: ~ 17'7Pi;~
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OWNER:
O\.JNERS ADDRESS:
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APPLICANT: m11'7 ,,--!A..MLJj~ ~ 'm/?.-tJ?-<:)
APPLICANTS ADDRESS: p/). ,,tL:v ,'-)"/3 I Q'j')AYP -It; idJ (ill (11~1/)
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 1LJI.."-=J:J.::U...,,
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PROPO::H~D USE: -J<r: . !/I/'ln'- //~'O ,,..",,Al,-'C! (l/':'''''-\i_d~r
A $30,~O INSPECTION ;EE IS R~QUIREDAT THE TIME cr-
OF APPLICATION
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THIS APPLICATION FORM MUST BE SIGNED BY THE OvrnER OF THE PROPERTY TO
BE INSPECTED.
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SIGNATURE OF PROPERTY OHNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
DATE OF REPORT:
RECEIPT NUMBER: D &'5-77 do
DATE PAID: IL- ~'-I--~ f;'"
DATE OF CERTIFICATE OF COMPLIANCE:
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!' ~ CITY OF SPRINGFIELD'
: Department of Planning and Deve ent
Building Safety Divisi
5th Street
Oregon 97477
726-3769 ,(Insp,)
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I 225 ,N~rth
I Springfield,
1726-3753 (Bus.)
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OCCUPfu~CY INSPEC~
APPLICATION
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SPRINGFIELD
DATE :9"(1 ,,?/, /C)rP5 ,
JOB ADDRESS: 1'-/-1 11"24//7
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OWNER:
O\VNERS ADDRESS:
APPLICANT: 7hM:CJ 'L-II? P/J/U.~ '-Ii J/ /n/LIfl.f ')
APPLICANTS AD~RES S : 12./). ~ /rY ,',),)3 \ 9)H1<..;"'/;; jri/ (;)/ ClJLJ1tJ
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 7LJ/b\-J:J.::?) ~
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PROPOS-ED USE: ~ /,,/-h-Yi/ /I {l ".jf- //'j-!J "'-M 1 ,-, c/ (l/I; ,'''''U' fl r
A $30.~O INSPECTION ;EE IS R~QUIRED AT THE TIME cr-
OF APPLICATION
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THIS APPLICATION FORM MUST BE SIGNED BY THE OvrnER OF THE PROPERTY TO
BE INSPECTED.
Wtu~rCcJ ID. p')
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SIGNATURE OF PROPERTY OHNER
FOR OFFICE USE ONLY
---------------------------------------------------------------------------
DATE OF INSPECTION:
RECEIPT NUMBER: L3 &-5'77 ~
DATE PAID: /L- ";;<L/-K S
DATE OF REPORT:
DATE OF
CERTIFICATE OF COMPLIANCE:
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COMMENTS:
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OCCUPANCY NAME Va.. (1, 0.....-1-
FIRE DEPARTMENT INSPECTION
CLASS
ADDRESS 7 7 <I /J1~ Sj.I/~rJ-
BUS. PHONE
OCCUP. NAME
HOME PH.
BUILDING OWNER
PHONE
ADDRESS
I CODE SECTION
VIOLATIONS
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YOU ARE HEREBY NOTIFIED TO CORRECT THE ABOVE VIOLATIONS WITHIN
DAYS.
SIGNED:
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VIOLATIONS: Noted
DATE ;j b/e$' ABATED
NUMBER