HomeMy WebLinkAboutPermit Fire Damage Report 1996-07-10SPRIIiGFIEI-} FIRE DEPAP.TMENT
FIRE DPJ1AGE REPORT
OR
ELECTRICAL HAZARD
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5 f'qb 2ort /
DATE: +- to-?<t
TO:
FR0r.1:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Building
Address or 'location of building tld z1L' 5+
Name of ot',ner
Type of building d.*- \t
(Dwell'rng,tore, InJar use, etc. )
Estimated value of buiiding
Estimated loss to buildinq
$ 8o. eo
$ {A.c)ao
Date of fire ? -t a-1L?
Location of damaoe in bui'ldinq R.,.,Ers
(Rcof, Wa1 1 , Exterior, Interjor, etc. )
Structural weakness as a result of the fire
(Burned rafters , Beams , .19i sts , etc. )
Add'itional pertinent jnformation
Electrical Hazard se_
cc:.)
r\
(l,/irinq, 0ut'l ets, etc. )
-t C/I
S iqned