HomeMy WebLinkAboutOccupancy Correspondence 1983-10-10
CITY OF SPRINGFIELD.
Department of Public Wo
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp,)
OCCUPANCY INSPEC~i
APPLICATION
SPRINGFIELD
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DATE: /0-10- t'3
JOB ADDRESS: 33'U> 12- JIYUl)STJ?IAL .-11/8 ~ '7IFL).
OWNER: Berry L-G/!./FF(Tff / jJAr/lICIA /11. KAA1/AJ(X) d64. 011 SH/ICT/
OIVNERS ADDRES S : "3 ~ J..O IfL- J IV IJ V 5'r;e tilt.- /t1J~ S P ft) ,
APPLICANT: f/g-rT Y 6fL/ ff/IH
APPLICANTS ADDRESS: 3;;2-{) ri- I/-./()(/S ~I/Jl- A1It5.
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER:
5PHJ '
71,/6-tJS"
PROPOSED USE: -:F/LK<C-I!-{gr"'v '-r I SIf-/I2.T /11~l)r-1c..:lvl2-~
A $30,00 INSPECTION FEE IS REQUIRED, AT THE TIME
OF APPLICATION -
THIS APPLICATION FORM MUST BE SIGNED BY THE OllliER OF THE PROPERTY TO
BE INSPECTED,
~oT:
SIGNA~ OF PRO
FOR OFFICE USE ONLY
DATE OF INSPECTION: \0 - \~ -~~
RECEIPT NUMB~~: ' tJ'J{%.V1
DATE PAID: r V ~,!. \() t
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
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