HomeMy WebLinkAboutOccupancy Correspondence 1996-12-2 (2)
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(541) 726,3753
FAX (541) 726.3689
OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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.l. L - L. - ~ l,o JOB NUMBER: 3.i.tJIJ;,] 'I
ADDRESS OF INSPECTION: ~LL l--~i ~ "::::.-\..
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PHONE NUMBER: -.:;.t.17-/~5 ~ .
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DATE:
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OIlNER:~l&. s... ,...~""-
O'JNER'S ADDRESS: ,,~loLl ~ 4 )oA..U .,4.(' e
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APPLICANT: ~ \ __~..""-
APPLICANT'S ADDRESS; 5:5,\ 1....U....."T1l:.R. c::A. 8:00"M:> ~c'.oo ":1-4'1-410",
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: \ G :0..... .,.... lJ,:l\OO <'c8Co..~5~H.
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PROPOSED USE: Io-AEXlCA/0 6- ~(?COOe.s)J 'YJmS ) I1\PES,
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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 OIlNER OF THE PROPERTY TO BE
INSPECTED.
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FOR OFFICE USE ONLY
DATE PAID:
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RECEIPT NUMBER:
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DATE OF INSPECTION:
DATE OF CERT1FICATE OF COMPLIANCE:
.DATE OF REPORT:
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COMMENTS:
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PROPOSED FLOOR PLAN REQUIRED AT TIME OF APPLICATION
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