HomeMy WebLinkAboutPermit Fire Damage Report 1987-05-21*tr7c3d7
FIRE DAI4AGE REPORT
OR
ELECTRiCAL HAZARD
DATE: -f - e-t- g,
TO:
FROI4:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Building
Address or'locat'ion of bu'ilding 71rs A/- 7t ft sl-
Name of orrner L*nn.Vr l1s.
Type of building
Estimated value of building
Es timated 'l oss to bu i I d i ng
(Dwel i ng, Store, l^lareho use , etc. )
$ loon .oc
$ ,c-an . r) E
Location of damage in building
(Roof, l,Jal l, Exterjor, Interior, etc.
Structural weakness as a result of the fire ht)NF-
)
(Burned raf ters, Beams, ,-loists, etc. )
Additional pertinent information
El ectri ca'l Hazard NnN E
(l,li ri nq , 0utl ets , etc . )
cc
S i gned
Date of fire -S- Ir - A?