HomeMy WebLinkAboutMiscellaneous Application 1986-06-26CITY OF SPRINGFIELD
Department of Planning and Devetopment
Bui'ldi ng Sa
225 NorthSpringfield,
726-37s3 (Bus. )
fety D
5th s
0rego
7 26-3
ivision
treetn 97477
769 (Insp.)
HOUSING INSPECTION
APPLICATION
SPRINGFIELD
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DATE:
JOB ADDRESS:+by fr
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OWNERS ADDRESS:
APPL]CAI{T:
7
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY--PLEASE I}ICLUDE TELEPHONE NI]MBER:3+"-4/ r
A $?(.OO I}IE'E€T-O}I EBF IS REQUIRED AT TIIE TII.IE OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED.
SIGNATURE OF PROPERTY OIINER
FOR OFFICE USE ONLY
DATE OF INSPECTION:RECEIPT NI]MBER:
DATE PAID:DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COTO{ENTS:
CITY OF SPRINGFIELD
Department of Planning and Development
Building Safety Division
225 North 5th StreetSpringfield, 0regon 97477
726-3753 (Bus.) 7?6-3769 (tnsp.)
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APPLICATION
PECTION SPRINGFIELD
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DATE:
JOB ADDRESS:,lby
OWNER:{
OI,INERS ADDRESS:
APPLICAI{T:
7
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY-.PLEASE I}ICLUDE TELEPHONE NI]MBER:
rs REoJTRED AT TIIE TrI'tE OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED.
SIGNATURE OF PROPERTY OWNER
FOR OFFICE USE ONLY
DATE OF INSPECTION:
DATE OF REPORT:
RECEIPT NIJMBER:
-
al a(DATE PAID:
DATE OF CERTIFICATE OF COMPLIANCE:
CO},I},IENTS
6.
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CITY OF SPRINGFIELU
Department of Planning and Development
Bui I di ng Safety Di vi s i on
225 North 5th StreetSpringfield, 0regon 97477
726-37s3 (gus.) 726-3769 (Insp.)
DATE:
1b8
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3Lv-5l',{
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APPLICATION
JOB ADDRESS:
OWNER:
OI,ilNERS ADDRESS:
APPLICAI{T:
7
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY..PLEASE I}ICLUDE TELEPHONE NI]MBER
CZ:,:.:. -
tu ir'-:r.
IS REQUIRED AT THE TIME OF
APPLICATION
TI{IS APPLICATION FORM MUST BE SIGNED BY THE OVTNER OF TITE PROPERTY TO BEINSPECTED. --
DATE OF INSPECTION:RECEIPT NT]MBER:
DATE OF REPORT DATE PAID
DATE OF CERTIFICATE OF COMPLIANCE:
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SIGNATURE OF PROPERTY OI^INER
FOR OFFICE USE ONLY
CITY OF SPRINGFIEL.
Department of Planning and Development
Building Safety Division
225 North 5th Street
Spri ngfi el d , 0regon 97 477
726-3753 (sus. ) 726-3769 (Insp. )
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APPLICATION
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JOB ADDRESS:
OWNER:
OI.ilNERS ADDRESS:
APPLICAI{T:
+bt n)
7
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY--PLEASE I}ICLUDE TELEPHONE NIIMBER:3+?-d
IS REQUIRED AT THE TI}IE OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY TT{E OI,TNER OF TIIE PROPERTY TO BE
INSPECTED.
SIGNATURE OF PROPERTY OI^INER
FOR OFFICE USE ONLY
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
RECEIPT NI]MBER:
DATE PAID:
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COI,IMENTS:
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DATE:
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