HomeMy WebLinkAboutPermit Field Test & Inspection Report 1996-05-27C'TY OF OFEGO'V
SPFlE.iJeIELO
D L v I : L O P
^t
t. N { S f: I 1 v I C { : S D L F tl R I ittl I : lt' l'
CITY OP SPRINGFIEU)
22s FlFl"ll Sfn/:II
{; I ) I I I NG F I l:l D, Otl 9/ 47 t'
(s41) 726-37s3
FAX (541) 726-368e
OCCT'PAI{CY INSPECTION APPLICATION
BUIIDING DIUTSION
q JOB NUMBER:Qtc-tV
rufr?5
DATE:
ADDRESS OF INSPECTION:
OIJNER:PTIONE NUMBER:
OI.INER' S ADDRESS:
E
APPLICANT:
APPLICA}IT'S ADDRESS:I
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
= = ====== = ======== = = ===== === == = = == = = = = ==== == = === === === ====== ===E=====E===========
PROPOSED USE:
A $gS.OO INSPECTION FEE IS REQUIRED AT THE TIME OF APPLIcATIoN
THIS APPLICATION FORM MUST BE SIGNED BY THE OIINER OF THE PROPERTY TO BE
INSPECTED.
sh rp
/nN
(re4u< LRrq>
SIGNATURE OT' PROPERTY OI.INER
FOR OFFICE USE ONLY
DATE PAID. 5- ZK -q A RECEIPT NUMBER:
DATE OF REPORT:DATE OF TNSPECTION:
DATE OF CERTTFICATE OF COMPLIANCE:
COMHENTS:
PROPOSED FLOOR PLAN REQUIRED AT TIME OF APPLibarpU