HomeMy WebLinkAboutPermit Fire Damage Report 1995-12-18CMY OF SPRINGFbI,D
Fire & Life Safety
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FIRE DAMA.GE REPORT
OR
ELECTR]CAL HAZARD
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DATE: lL -Lg -a5
TO:
FROM:
SUBJECT:
Bui'lding Department
Spri ngf i e'l d . F'i re Departrnent
Structural Damage to Bu'i 'l di ng
Address or'location of building ll+-7 -7r9
Name of orcrner
Type of bu i 'ld'ing
(Dwe'l'li , Store, llarehouse, etc.
Estimated va'lue of bui 1d'ing
Estimated 'loss to bui 1d'ing
$ (\0.0 od-
Date of tire lZ-l ?-75
Locat'ion of damage in bui'ld'ing 5F ,; rl< o? h ous c a"t
e lec*ric..l (q zto,r e rte- i cf
$
(Roof , l,'la'l 'l , Exterior, Interior, etc.
Structural weakness as a resu'lt of the fire
(Burned raf ters , Beams , ,-10'i s ts , etc .)
Additional pertinent jnformation
E]ectri ca'l Hazard /Uo e /e v,'. c- / fv*.-
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(tlli ri nq , 0ut'l ets , etc.
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S'igned
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