HomeMy WebLinkAboutOccupancy Application 1986-07-18CITY OF SPRINGFIELD
Department of Planning and Devel-t-rpment
Building Safety Division
225 North 5th Street
Spri ngfi el d, 0rego n 97 477
726-3753 (Bus.) 726-3769 (Insp.)
DATE:Fqac5Oi>-
JOB ADDRESS:o
O}trNER:
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OI.INERS ADDPGSS:1o=4 /14 nu4
OCCUPANCY INSPEChON
APPLICATI
SPRINGFIELD
APPLICANT:
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TE LEPHONE ER 7
PROPOSED USE:L
A $ 35.00 INSPECTIoN FEE IS REQUIRED AT TFE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY T}IE OI.]NER OF THE PROPERTY TO
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SIGNATURE OF PROPERTY Otr{NER
FOR OFFICE USE ONLY
DATE OF I}ISPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF CO}{PLIANCE:t,
COMMENTS:
RECEIPT NUMBER:/"/" /)bt
DATE PAID:q4 v-8 b
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BE INSPECTED.
CITY OF SPRINGFIELD
/epartment of Planning and Devetopment
Buildin,g Safety Division
?25 North 5th StreetSpringfield, 0regon 97477
726-3753 (Bus.) 726-3769 (lnsp.)
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DATE:FQac5)ix
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JOB ADDRESS:o
OWNER:
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OI{NERS ADDPGSS:4o=4 /14 ncn-
0CCUPANCY IIJSPECIrON
APPLICATI
SPRTNGFIELD
APPLICANT:
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY-.PLEASE INCLUDE .TELEP}IONE 7
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PROPOSED USE:V-td-O
A $ 35.00 INSPECTIoN FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY TIIE OIINER OF THE PROPERTY TO
BE INSPECTED.
6>L
SIGNATURE OF PROPERTY OI{NER-.
FOR OFFICE USE ONLY
DATE OF IItrSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF CO},IPLIANCE:
COMMENTS:
RECEIPT NI]MBER:br,0 b I
DATE PAID:q4 v-8
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CiTY OF SPRINGFIEI-D
Department of Planning and Deverwpm€flt
Bui'ldi ng S
??5 Nort
Springfield
726- 3753 ( gus.
5th Street
0rego n 97 477
726-3769 (insp. )
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afety Divis'ion OCCUPANCY INSPEC'I.uN
APPLICATI
SPRINGFIELD
APPLICANTS ADDRESS:
FOR ACCESS TO PROPE RTY--PLEASE INCLUDE TELEPIiONE NI]MBER:7
PROPOSED USE:6teL
A $ 35.00 INSPECTIoN FEE IS REQUIRED AT TIIE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OITNER OF THE PROPERTY TO
BE INSPECTED.
6V.
SIGNATURE OF PROPERTY OI{NER
FOR OFFICE USE ONLY
DATE OF I}trSPECT].ON:
DATE OF REPORT:
DATE OF CERTIFICATE OF CO}{PLIANCE:
COMMENTS:
RECEIPT NUMBER:/,/"0bl
DATE PAID:q4 v-8
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APPLICANT:
NESCR I OCCUFANCY II'ISF'ECTIOI'{
..Ot,l'lER-
CHURCH Oi BRETHERI{ 746'14?9
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irnruerrELrrr oREGol't 97477
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001-025-0CCUF.ANCY ll.lsP A 30.00 0.o0 841212 63984
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