HomeMy WebLinkAboutOccupancy Application 1997-03-25CITY OF SPR OREGO'U
SI,h-r{GFIELD
BIIII,DING DI\ESION
JOB NUMBER:
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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
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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
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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:
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COMHENTS:
RECEIPT NUMBER:
DATE OF REPORT:
PROPOSED FLOOR PLAN REQUIRED AT TIME OF APPLIGATION
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