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:
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-
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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
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FOR
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TELEPHONEO (.--- PLEI\SE CALL
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TELEPHONED PLEASE CALL
CAME TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU RUSH
RETUHNED YOUR CAIL SPECIAL ATTENTION
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