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HomeMy WebLinkAboutOccupancy Application 1997-03-25CITY OF SPR OREGO'U SI,h-r{GFIELD BIIII,DING DI\ESION JOB NUMBER: 2Zs Ftt:'f\ -sf/l[ijI SPRINGFIELD, OR 97477 t.t (s41) 726-s7ss FAX (541) 726-368e DEVELOI'}MENI S{:l:lvlcES DEI}AB f MENf CITY OP SPRINGFIEI.D DATE: ADDRESS OF INSPECTION: OCCTIPANCI INSPECf,ION APPLICATION a 31 O1JNER:l)u rt| [,''o, t I f-o ,r-/rrt PHONE NUMBER: 6€E-oo445.c OI{NER'S ADDRESS:b o APPLICANT:9. APPLICAI.IT, S ADDRBSS :a{ FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:G8&- fo I lJ 7s 7 {L t1. 7)a - {-/.f / PROPOSED USE:U€,,,p A S35.OO INSPECTION FEE IS REQUIRED AT THE TIME OP APPLICATION THIS APPLICATION MUST BE SIGNED BY THE OI.INER OF THE PROPERTY TO BE rOR OFFICE USE ONLI DATE PAID:Z DATE OF INSPECTION: DATE OF CERTTFICATE OF COMPLIANCE: . -r11. COMHENTS: RECEIPT NUMBER: DATE OF REPORT: PROPOSED FLOOR PLAN REQUIRED AT TIME OF APPLIGATION 2{, / ,