HomeMy WebLinkAboutBuilding Application 1990-11-19SPRINGFIELD
lanning and gsy -'rpmertt
Safety Divisth 5th Streetd, 0regon 97477.) 726-376e (Insp.)
^ITY OF
:partment of P
Building
225 NorSpringfiel
726-3753 (Bus
HOUSING INSPECTI
APPLICATION
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SPRINGFIELD
DATE:
JOB ADDRESS:,4
OhrNER:Fl,C
OWNERS ADDRES o e
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APPLICAT{T:
APPLICANTS ADDRESS: 23 7 g L ilr,* /.? G /ore/a . h^< -g z t/gz
:ASE rNCLU(E TELEPHoNE **r[* ,4 ' (- 8-/ 0as:6
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A $35.00 INSPECTION FEE IS REO.UIRED AT TIIE TII.IE OF
APPLICATION
THIS APPLICATION FOR},I MUST BE SIGNED BY TI{E Oi,,'NER OF THE PROPERTY TO BE
INSPECTED.
OF PROPER.TY OWNER
FOR OFFICE USE
DATE OF INSPECTION:RECEIPT NIDIBER:
DATE OF REPORT:DATE PAID:
DATE OF CERTIFICATE OF COMPLIANCE:
CO}O{ENTS:
COURTESY INSPECTION APPLICATION
(RENTER REQUEST)
CITY OF SPRINGFIELD BUILDING DIVISION
DATE \
OI,\INER koift O\.,"k
ADDRESS OF INSPECTION 3
PH.NE *o%01 as HcrsA&l-
t,
pt - Zfz -6oo
ADDRESS
RENTER PHONE NO.
SIGNATURE OF OCCUPANT (RENTER)
FOR ACCESS TO PROPERTY - TELEPHONE NLJMBER 7 /7 -A 72,4 ,1--"/x
TYPE OF DWELLING: SINGLE FAMILY n DUPLEX n MULTIPLE tl
BRIEF DISCRIPTION OF MAJOR PROBLEMS:n
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FOR OFFICE USE ONLY
Date of Inspec tion
Courtesy Letter Sent
Notice and Order Issued To Owner
Date For Comp liance
Compl iance 0btained - Date
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