HomeMy WebLinkAboutPermit Fire Damage Report 1994-09-05SPRI};GFIEL} FIRE DEPAN.T}lENT
FIRE DA},IP.GE REPOP.T
OR
ELECTRICAL HAZARD
?-t/;ro
3Fq*'z''lK'/
DATE:$L+
fO,
FROI4:
SUBJECT:
Building DePartment
Springfield Fire DePartment
Structural Damage to Building
Name of ot{ner D.-. ")ll'. a'aJ
Type of building s OfCt o/
Dwe'lling, Store, l'larehouse, etc.
Est'inrated va]ue of bui'ldi n-o S l0OO . -
Estimated I oss to bu'i1di ng s 100 o.-
Date of fire 1-r--c?t
Location of damage in bui'lding
?..'+ ut'.-ll I
-T-lJ - t lr,1C
nte v', t'-
(Rcof, l,Ja1 I , Exterior, Interjor, etc.)
Structural weakness as a result of the fire ef
(Burned rafters , Beams , "1oi sts, etc.
Addjtional pertinent information
El ectri cal Hazard
(l'lirinq, 0utlets, etc. )
cc:a b-q4
Siqned
,
Address or location of buildi ng Ztcl S 1z^!
)