HomeMy WebLinkAboutPermit Fire Damage Report 1996-06-02CTTY OF SPRINGI JLD
Fire & Life Safety
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FIRE DA!'4AGE REPORT
OR
ELECTRlCAL HAZARD
DATE: /: / - q 6
TO:
FR0l''i:
SLI BJ E CT
Date of fire
Bu'ilding Departrnent
Springfield Fire Department
Structural Damage to Bu'ii d'ing
Address or location of bu'i'lding i 3 0c>ltc,/*,,k
Name of or.rner Q,r/*ul ili./|l, ,,
T-vpe of building P*, I G,-i t/
(Dwel 'li ng , Store, I,Jarehouse, etc. )
S rao.ooa-Estimated val ue of bui I d'ino
Est'imated loss to build'inq '[o s%.-rl
6- t - q6
Location of damaqe in buildinq /u. .\i y'e
(Roof, l,'lal l, Exterior, Interior, etc. )
Structural weakness as a result of the fire E-
(Burned rafters, Beams, .1oists, etc. )
Additional pertinent infor^mation
Electrical Hazard \
(l,ji ri nq , 0utl ets , etc . )
b 4 cib ?.t, a ..sCC
a
Siqned &,,,r) '/l/until,
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