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HomeMy WebLinkAboutPermit Fire Damage Report 2004-01-12FD-016 TO: FROM: SIJBJECT: Building Department Springfield Fire Department Structural Damage to Building FIRE DAMAGE REPORT OR ELECTRICAL HAZARI) 3A'3 3 K*fl.el Date:_ ,/ Z__ <> LA,DD\o\ Address or location of building Name of Owner L.. Type of Building C.)ltr l" Estimated value of building -^--L: @welling, Store, Warehouse, etc.) $7 D@ Estimated loss to building $Za<) Date of fire Location of damage to building Additional pertinent information (Roof, Wall, Exterior, Interior, \L// e.- -a> etc.) Structural weakness as a result of the fire t-o2 (Burned rafters, Beams,Joists, etc.) e-/,; a Electrical Hazatd ,d (Wiring,Outlets, etc.) CC V:\FD-FORMS\FD{16 FIRE DAMAGE REPORT'doc Signed I