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HomeMy WebLinkAboutOccupancy Correspondence 1990-9-4 CITY OF SPRINGFIELD Department ?f Planning an~ D~v:~ment Buildlng Safety D1V1Sl'" 225 North 5th Street Springfield, Oregon 97477 " 726-3753 (Bus.) 726-3769 (Insp.) nO~'~C;?I-/:lO~b.:tJ::: qvll/?_ ,C:~nt' ~mbs>'" 4. 1990 V OCCUPANCY INSPEC~ APPLICATION SPRINGFIELD DATE: JOB ADDRESS: OWNER: "l4Q M"in Street ~nhn Bentzen. Trustee i OIVNERS ADDRESS: IRIS Clement Ave.. Alameda, CA 94501 APPLICANT::fnh MCCul\or h-=-Qm1''lJl Qp(L.o F~~ APPLICANTS ADDRESS: '7t./ r I ~r/!J ~I=-If Ilr-IJ~(\l' t:J7!:/:..Q.1 FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: ~fLi~ j/~o~ , I?ea1 f~.-k, r&b mC0}//otfl (,,87-d(nl?' OV- .5:n.A'-fh.[Qce- rr7M<?dvur-Hb1 , PROPOSED USE: tf:h r .. 9fh r.p . ?1' d:- 7 Lj I - 2AD "in A $ 35.00 INSPECTION FEE IS REQUIRED, AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OvffiER OF THE PROPERTY TO BE INSPECTED. ~ ~!I~).J.j~ _i~h'- ~ SIGNATURE OF PROPERTY ~R ~, FOR OFFICE USE ONLY --------------------------------------------------------------------------- DATE OF INSPECTION: RECEIPT NUMBER: I k?22-- DATE PAID: q .{p-7iJ DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: