HomeMy WebLinkAboutPermit Fire 1996-02-02CTTY OF SPRII\ I.IELD
Fire & Life Safety
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FIRE DAIVIAGE REPC)RT
OR
ELECTRICAL HAZARD
DATE:A-*-E(
TO:
FROI{:
SUBJECT:
Building Department
Springfield Fire Departnent
Structural Damage to Buiiding
ru. s*! srAddress or location of buildinc
Name of ot{ner L/
Type of building
(Dwel I
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, Store, I^larehouse, etc. )
Est'imated val ue of bui 1di ng
Estimated loss to buildinq
Date of fire
$
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L- ?- -q L
Location of damage 1n buiidinE TV iio,r^i, e'x N-st(e N.iZ, Corwor
(Roof, l,Jal'l , Exterior, interior, etc.)
Structural weakness as a result of the fire
(Burned raf ters, Beams , .ioi sts, etc.)
Addi ti onal perti nent 'i nforma ti on
Electrical Hazard )s-
(l,lirinq, 0utlets, etc. )
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S'i q ned *i/. m,t tap *V
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