HomeMy WebLinkAboutPermit Fire Damage Report 1998-10-24rna/*rare-l 7Q 3z/3 /L3
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE:iolzl kg
TO:
FROI'I:
SUBJECT:
Build'ing Departrnent (t*"\)
Spri ngfiel d' Fi re Department
Structural Damage to Building
Address or location of building >(>))C";ol<-
Name of or./ner
Type of buiiding +'
Dwel I i ng, Store, lrlarehouse, etc. )
Estimated value of buildinq b in.
Estimated loss to building $'3,q)J
(
Date of fire (
Location of damage in building
(Roof , lnJal I , Exterior, Interior, etc. )
Structural weakness as a resu'lt of the fire
(Burned rafters, Beams, r'!oists, etc. )
Additional pertinent information
Electrical Hazard
(Wiring, 0utlets, etc. )
cc rl- 3'q g ?ttl Signed