HomeMy WebLinkAboutBuilding Application 1990-04-20CITY OF SPRINGFIELD
Department of Planninq an, -ev rpment
Building SafetY Div lS'luo
225 North 5th StreetSpringfield, 0regon 97477
726-3753 (Bus.) 726-3769 (Insp.)
HOUSING INSPr- .'I(
APPLICATION
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JOB ADDRESS:
owNER, -TL
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lbb frtt,*u,^tLBltdOWNERS ADDRESS
APPLICAI{T:fk- 2rz-sP12
APPLICANTS ADDRESS: 37OO O,*0t o7L
FOR ACCESS TO PROPERTY--PLEASE I}ICLUDE TELEPHONE NI]MBER:.t-11
A $35.00 TNSPECTTON FEE rS REQUTRED AT TI{E Trl,{E OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OhT{ER OF THE PROPERTY TO BE
INSPECTED.
SIGNA OF PROPER.O\^INER
FOR OFFICE USE ONLY
DATE OF INSPECTION:RECEIPT NUMBER:1
DATE OF REPORT:DATE PAID:
DATE OF CERTIFICATE OF COMPLIANCE:
COM{ENTS:
SPRINGFIELD