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HomeMy WebLinkAboutPermit Fire Damage Report 1986-07-18rD-16 5FE['/Ll3{ 050 tr FIRE DAMA.GE REPORT OR ELECTRICAL HAZARD TO: FROM: SUBJECT: Name of ov/ner Type of building Bui'lding Departrnent Springfield Fire Department Structura'l Damage to Bui 1 di ng Address or location of building ts55 /v- )1"! ()+f ) q)2 \l (i ng , Store, l^larehouse, etc.) Estimated val ue of bui'ldi ng Estimated loss to building $3 Z^ ooO $I 5oo Date of fire ?' t3'Nb Location of damage in building 0 rE .C<)c) I (Roof , [,Jal I , Exterior, Interior, etc. Structural weakness as a resu'lt of the fire q-r ?l^ (Burned rafters , Beams, Joi sts, etc. ) Additional pertinent'information Electrical Hazard Lr)\r cc: Siqned ?r (l,{i ri ng , 0ut'l ets , etc. ) fr:4 - DATE: 7' /8' i6 ,A- ,A frf,fu //@ bvn*eA wryll/q /D dA{rTdE, (Ulpil fr'Et1-