HomeMy WebLinkAboutPermit Fire Damage Report 2004-03-20FD-o16
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARI)
TO:
FROM: .:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Building
Date: 03-20-04
C+ooa\o
/&\Address or location of building 1300 6th st.
Name of Owner Ellingen, L udvig
Type of Building Dwelling
@welling, Store, Warehouse, etc.)
Estimated value of building
Estimated loss to building $ under investigation
Date of fire 03-20-04
Location of damage to building Extierior Wall back of structure
Eoof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
ElectricalHazard, Wirin
(Wiring,etc.)
Signed
CC:
C:\Documents and Settings\hall6S40.SPRINGFIELDl\Desktop\Report Forms\FD-0I6 FIR-E DAMAGE REpORT.doc