HomeMy WebLinkAboutPermit Fire Damage Report 2002-04-24OZ-oo s-oo - .1 ,rD-16
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
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DATE: '/ * 3t ?- o 1
TO:
FROM:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Buildino
Address or location of building /65 \q'/ !!t,
Name of ot^/ner /_
Type of bui'lding IA
11ing, S tore , [.larehouse, etc.
Estimated value of building ioo OG
Estimated loss to building 500.r
Date of tire f*?"oE*
Location of damage in buiiding {//c,1o^Aa e*
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(Roof, l,,fa I 1 , Exteri oF, Interior, etc. )
Structural weakness as a result of the fire 7?t?rl / c
(Burned raf ters, Beams, Joists, etc. )
Additional pertinent information
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E'lectri cal Hazard
(Wiring, 0ut1ets, etc. )
Signed
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