HomeMy WebLinkAboutPermit Fire Damage Report 2000-09-17fob tL 0o- pt.l 3Q _ o t YV,p of g-llJ--[ 6
TO:
FROM:
SUBJECT:
FIRE DAMAGE REPORI
OR
ELECTRICAL HAZARD
Bui?ding Department
Springfield Fire Department
Structural Damage to Building
{^1aL( IILL/t70 q
DATE: ?, ta ,O o
Address or location of building _37 5 S ,*8t:\
Name of or./ner
Type of building
i1ing, Sto re, l^la rehouse, etc. )
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Estimated value of building
Estimated loss to building $/, ooO
$/2 o a
Date of fire ,o
Location of damage in buitding k;ka.,n
(Roof, ltlal l oF, Interior, etc.)
Structural weakness as a result of the fire
(Burned ters, Beams, Joists, etc. )raf
Additional pertinent information
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Signed
etc.
eElectrical Hazard
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