HomeMy WebLinkAboutPermit Fire Damage Report 1999-01-31lT oblul-03(o-'b ??.lzo?I' Srl 1 c=al
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
5
DATE: r-)t-3r-'i
p{
1
TO
FR0t"1:
SUBJECT:
Building Department
Springfiel d' Fi re Department
Structural Damage to Building
-1"Address or'location of build'ing C
Name of or./ner
Type of buiiding A, ^.] ,q t -'Lf (..n / /c,
Estimated value of building /.9 0 Coo. -
T
Estimated loss to building $ 5 ooo.
Date of fire crr- f l- ta
Location of damage in building e . S-t o, ,^4
) rSG t /r:f7^,, -F*+t) - ln/a I I
(Roof, WaIl, Exterior, Interior, etc.)
Structural weakness as a result of the fire /r/o
(Burned rafters, Beams, .)oists, etc. )
Addit'ional pertinent information
E'lectri cal Hazard
(Hiring, 0ut1ets, etc. )
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(CC
Signed