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HomeMy WebLinkAboutPermit Occupancy 1996-03-04D EVELOPM ENT S E RVICES DE PARTM ENT CITI OF SPRINGFIEU) SPFrINGFI OCCTIPAIICY INSPECTION APPLICATTON ELc, 225 FIFTH STREET SPRINGFIELD, OR 97477 (541 ) 726;3753 FAX (s41) 726-368e BUTIJING DIYISION CITY OF SPRINGFIELD, O.FEGO'V DATE: ADDRESS OF INSPECTION: // 7 4/ 2 / 'J JgB NUMBE* 32tZ*a- OIJNER:c^*A /* r,r ntA PHONE NUMBER: 7./ f -{/410 OIJNER'S ADDRESS:7c tt 9'7 tC APPLICANT: APPLICA}IT'S ADDRESS: FOR ACCESS TO PROPER * l-G C- qe /\ 7a ol o TY - TELEPHONE NUMBER: 7tf Cr r/ o 7r-,53 7 PROPOSED USE: A ta1 tz sew € yt,/Ce o -u. THIS IN A 5.OO INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION UST BE SIGNED BY THE OI.INER OF THE PROPERTY TO BE FOR OFFICE USE ONLY DATE PAID, 3 -"'%,DATE OF INSPECTION: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: RECEIPT NUMBER: DATE OF REPORT: r' r1i^.' =r?'i!::' t