HomeMy WebLinkAboutOccupancy Application 1987-08-04.{"iTY OF SPRINGFIELD
Oepafirt15nt of Pl anni ng and Del pment
Building SafetY D'iv'ist-,
22.5 North 5th StreetSpringfield, 0regon 97q17
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY I].{SPEL
APPLICATION
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DATE:
JOB ADDRESS dt 4
OWNER:
O!.II$ERS ADDPGSS
APPLICANT:14 a -)a
APPLICANTS ADDRESS
FOR ACC ERTY--PLEASE INCLUDE TELEP}IONE NUMBER
C,e/dSrPrs
PROPOSED USE:J.
A $ 35.00 TNSpECTToN FEE rs REQUTRED AT TIE TrME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED Y T}M OIINER OF THE PROPERTY TO
BE INSPECTED.
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SIGNATURE OF PROPERTY OI^]}]ER.
FOR OFFICE USE ONLY
DATE OF I}ISPECTION RECEIPT NUMBER:6t 8'/s /,
DATE OF REPORT:DATE PAID:t-U-r t
DATE OF CERTIFICATE OF CO}{PLIANCE:
CO}EVIENTS
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INSPECTOR
ctrY 0F's INGFIELD
346 rvtAlN STREET ';
INSPECTED THE ELECIRICAL WRING AT.ID EQUIPMENT INSTATITD BY YOU AT
oryu{ER oR
TENANT
TOCATION OF
JOB
E WRTNG APPROVED FOR CO\fER ,i. i,', ,' :'l
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tr wmlt.re, cov,ERED WmtOtrr tt.lspEcltoht
E DUE TO THESE PRE^ ISES BBl.tc LOCK,ED AI\t ttISpECnoN cottD
E DUE TO NO O}.c HOME All tNSpEctoN coutD NoT.BE |{ADE
FOR
. E HEAT CABTE APPROVED FOR COVER
, E UNDERGROtttto'11rplovED FoR covER
E CONDUIT SYSTEM APPROVED FOR COVm ..
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726-3753 (gus.
Cal
Y OF SPRINGFiELDof Planning and Det SPRINGF]ELD
afety Div'i sion
h 5th Street
, 0regon 97477j tzo:31G9 (Insp.)
DATE:
JOB ADDRESS:
OWNER:
OI'INERS ADDPJSS:
APPLICANT:
APPLICANTS ADDRESS
FOR ACC
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PERTY--PLEASE INCLUDE TELEP}IONE NUMBER:
4r 6r-ruts
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PROPOSED USE:
A $ 35.00 TNSPECTToN FEE rs REQUTRED AT TtE TrME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY TI{E OIINER OF THE PROPERTY TO
BE INSPECTED.
SIGNATUP.E OF PROPERTY OI^TNER
FOR OFFICE USE ONLY
RECEIPT NIIMBER l8'/3DATE OF I}ISPECTION
DATE OF REPORT
DATE OF CERTIFICATE OF COMPLIAI{CE:
COMMENTS:X u -Y/& ]L.L 0"
5'r.n*ott
DATE PAID:
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APPLICATION
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lob C.{umber r ,INSPECIOR G#*.:,r;|lt ,oAE{^D_ ',or,'t';Bhi/LI
CITY
BUITDING DIYISION 346 MAIN STREET 726-3759
HAVE INSPECTED THE ELECIRICAL WRING AI{D EAUIPMENI INSTALED BY YOU AT THE PREMISES NArvlED HEREIN AND SUBMIT
YOUR
OryVNER OR
TENANT
TOCATION OF
JOB
,,EI APPROyED FOR.,SERVICE. E HEAT CABLE APPROVED FOR COVER
E] WRING INCOAAPIETE E UNDERGROT'ND AFPROVED FOR COVER
E WRll.lG COVERED WffiOUT h{SPECflO}l E CONDU]T SYSTEM APPROVED FOR COVm
E DUE TO THESE IREMISES BENG LOCK,ED AN INSIECTION CO,t,LD tiCr,r pe IilADE
E DUE TO NO ONE HOME Ar{ TNSPECTON COULD NOT BE A A,DE . ! ,,,
u WIRING FOR COVERING
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FOIIOWING ,:
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CiTY OF SPRINGFIELD
Department of Planning and Der -- rpmsnt
Building Safety Djvision
?25 North 5th Street
Spri ngfi ei d, 0regon 97 477
7?6-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY IIJSPECnON
APPLICATION
SPRINGFIELD
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DATE:
JOB ADDRESS 4
OWNER:
OI'INERS ADDP.ESS:
14to -)a
APPLICANTS ADDRESS:I
PERTY--PLEASE INCLUDE TELEP}IONE NIIMBER:
?arus6rPts
PROPOSED USE:/"
A $ 35.00 INSPECTIoN FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION EORM MUST BE SIGNED Y THE OIJNER OF THE PROPERTY TO
BE INSPECTED.
SIGNATURE OF PROPERTY OI{NER.
FOR OFFICE USE ONLY
DATE OF I}trSPECTION:RECEIPT NIIMBER:6t"t'/3 /,
DATE OF REPORT DATE PAID:tr-q-r I
DATE OF CERTIFICATE OF CO}4PLIANCE
COMMENTS:
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APPLICANT:
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Pl anni ng & Devel opment - JITY OF SPR,I}qGFIEI,:
OFFICE OF COMMUNITY AND ECONOMIC DEVELOPMENT
Building D'ivision
Job. No.
JOB ADDR
t ;sr,rr-j64 O,
ZAL 225 North 5th Street
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Da te
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CALL FOR REINSPECTI0N L?.--INSPECIOR
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**** CALL F0R: -__ INSPE CIION /zb -3769 _---INFO RMA 7 26-3753 ****
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