HomeMy WebLinkAboutPermit Fire Damage Report 2001-04-2417 o > 3? // 7a?o?
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Fire & Life Safety
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FIRE DAI.4AGE REPORT
OR
ELECTRICAL HAZARD
DATE:Ar/OI
TO:
FROM:
SUBJECT:
Bujlding Department
Spri ngf i el d F'ire Department
Structural Damage to Bu'i1 di ng
Address or'location of building bcrt4,1 T*-, cz-!\b-\
Name of ot{ner M.r*s..,*) N xrsv
Type of building
(Dwel 'l i ng , Store, I^larehouse, etc. )
Estimated value of building
Estimated loss to buildinq $
DC)
,C-', OD c)
Date of fire LT 2
Locat'ion of damage in building A
(Roof, Wa1 I , Exterior, interior, etc.)
Structural weakness as a resu'lt of the fire f\)."*e-
(Burned rafters, Beams, .1oists, etc. )
Additjona'l pertinent'information
E'lectrical Hazard ?rq"" t'
?crP"Eb
(Wiring, 0utl ets, etc.
,r,?lt-).C
S i gned