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HomeMy WebLinkAboutPermit Field Test & Inspection Report 1984-07-16CITY OF SPRINGFIEL , Department of Publ i c tlorks Building Safety Division 2?5 North 5th Street Spri ngfi el d, 0regon 97 477 726-37s3 (Bus.) 726-3769 (Insp.) OCCUPANCY I}JSPECTION APPLICATION aFolry DATE: JOB ADDRESS: lLlb ttoAaerc OWNER: oT,,INERS ADDP,.ESSt /335. ril*Z4ef ,y' APPLICANT: I=ENOK (C-Ob'Paeic rE l%Z; ./tr e 55zoz.691=a<7>6-gG -= =>.6 APPLTcANTs ADDRESS: 6 tO Eosl BfroJa/a*r. €r9"o- FOR ACCESS TO PROPERTY..PLEASE INCLUDE 'U""*6**UU*, 72b. /g?O PROPOSED USE: SPRINGFTELD A $30. OO INSPECTION FEE IS REQUIRED AT T}IE TIME OF APPLICATION THIS APPLICATION FORM I'{UST BE SIGNED BY TI{E OI.INER OF THE PROPERTY TO BE INSPECTED. \, SIGNA OF PROPERTY Oi.INER FOR OFFICE USE ONLY DATE OF IIISPECTION : ? ^/ 2- E y RECEIPT NIIMBER :R<==?/ DATE OF REPORT:DATE PAID: DATE OF CERTIFICATE OF CO}{PLIANCE: COMMENTS:D€-! I 'F/:? CiTY OF Department Building 2?5 NorSpringfiel 726-3753 (Bus SPRINGFf Publfety D 5th s 0rego 726-3 IELL 'i c llorksivision treetn 97 477 769 (Insp. ) o Sa th d, .) OCCUPANCY INSPECTION APPLICATION aFo/77 DATE: JOB ADDRESS: lLtb tll o ,/rq d/c OWNER: OI,INERS ADDRESS: / APPLICANT: I=ENOK /, EO A '-/Z r Szos.6-eG -=>>6 APPLICANTS ADDRESS:f FOR ACCESS TO PROPERTY--PLEASE INCLUDE €tU€- NI]MBER 72b- /8?o PROPOSED USE: SPRINGFIELD , A $30. 00 rNSpEcTroN FEE rS REQUTRED AT TlrE TrME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OI.INER OF THE PROPERTY TO BE INSPECTED. \, SIGNATU OF PROPERTY Otr{NER. FOR OFEICE USE ONLY DATE OF I}ISPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF CO},IPLIANCE: RECEIPT NIIMBER , B T=Z? / DATE PAID: COMMENTS: ./ilc- t4t4zdtcr4// - - ?oeglc t5 2- ar a- CITY OF SPRINGFIELL , Department of Publ ic l^lorks Bui 1 di ng Safety D 225 North 5th SSpringfield, 0rego 726-3753 (Bus.) 726-3 DATE JOB ADDRESS: ivision treetn 97 477 769 (Insp.) OCCUPANCY II.JSPECTION APPLICATION 8Fo/77 tir o rlt o td/c OWNER: OT,.INERS ADDRESS: / APPLICANI: FE%,,IK 1a bs ./Z s 5.S.zoz.c eG -= =>6 APPLICANTS ADDRESS:I / FOR ACCESS TO PROPERTY--PLEASE INCLUDE ?/u4 NIIMBER . 72b- /83O E, PROPOSED USE: SPRINGFIELD A $:O.OO INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY TI{E OI.'NER OF THE PROPERTY TO BE INSPECTED. \, SIGNA OF PROPERTY OI.INER FOR OFFICE USE ONLY DATE OF IIISPECTI AN: / -/7"2 t/ DATE OF REPORT: DATE OF CERTIFICATE OF CO}{PLIANCE: RECEIPT NIMBER , B Z=Z? / DATE PAID: COIeffiNTS , /0, ),i 4 c o1e44i 2- ar €-h OCCUPANCY II.JSPECTION APPLICATION aFo"77 DATE JoB ADDRESS: lLtb tllo u/4 OWNER: OI,INERS ADDPGSS: / APPLICANT: APPLICANTS ADDRESS: 6I FOR ACCESS TO PROPERTY--PLEASE INCLUDE ZL(/ NUMBER. 72b- /3?O uoc =>.6 €,U€- PROPOSED USE: CITY OF SPRINGFIEL 1 Department of Publ i c rrr.rFksBuilding Safety Division 225 North sth StreetSpringfield 726-3753 (gus. 0regon 97 477 726-3769 (Insp.)i SPRINGFIELD A $30.00 TNSPECTTON FEE rS REQUIRED AT THE TrME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OI{NER OF THE PROPERTY TO BE INSPECTED. \, SIGNA OF PROPERTY OWNER. FOR OFFICE USE ONLY DATE OF I}ISPECTION DATE OF REPORT: DATE OF CERTIFICATE OF CO},{PLIANCE: COMMENTS: RECBIPT NI]MBER:B<=z?/ DATE PAID:7- af €ra a M FOR c]ATE M OF PHONE AR€ACM€ by TELEPHONEO (.--- PLEI\SE CALL c-- CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU FUSH RETURNEO YOUR CALL SPECIAL ATTENTION Iu I ,t,-= I FOFI DA M OF PHONE L{* - AFIEA COOE A.N,4. TIME oo rlo NUMEEF EXTENSION .4 SIGNED A* LITHO IN U.S.A. TOPS FOFIMSOO2P N/ESSAGE )a TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETUHNED YOUR CAIL SPECIAL ATTENTION lDlE lpAtptt,s,UENr OF lPlUlDlLlt rD W,DlplKS LORNE PLEGER ,r/rar*a c.?r,r4 Sray>-> /zt6fkffi4 6cvD ' fr., ,/?frteap y'*.rr€;7 cqrq* z?za7aroZf fi+VV; p*rf 6treP ' 6Zrra OFFrzry -