HomeMy WebLinkAboutPermit Fire Damage Report 2003-11-03o3-tL+ 3bq,1
FD-016
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARI)
Building Department
Springfield Fire Department
Structural Damage to Building
Address or location of building tast ,-gt3 5{
TO:
FROM:
SUBJECT:
Date:.A(cv 3, 03
Ui-Dt?D5
Name of Owner tt1 1*-ro
Type of Building o (<, (Jl
Store, Warehouse, etc.)
Estimated value of building $/ao, ooo
$'zd tta2Estimated loss to building
Date of fire NoV Q) , '?cc 3
Location of damage to building z,Q. {'.in,r
(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire e a ( Wq-[Cca€ ,CC
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard ( ,€ h o.A"J e
(Wiring,
Signed
CC:
V:\FORMS_FDs Fire Dept\FD-0I6 FIRE DAMAGE REpORT.doc