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HomeMy WebLinkAboutOccupancy Application 1990-05-17CiTY OF SPRINGFIELD ,artment of Plann'ing and Deve, rment Building Safety Divisi._ 225 North 5th StreetSpringfield, 0regon 97471?6-3753 (Bus. ) tZ6-3769 (Insp. ) DATE . ,;?o JOB ADDRESS:dt Otr{NER:\/1 OI{NERS ADDRESS: APPLICANT: 0 APPLICANTS ADDRESS:q?-,?,€_ t)- tt I \a ( OCCUPANCY INSPECT APPLICATION I SPRINGFIELD ->\ ACCESS TO PRO PERTY--P EIN TELEPITqNE NUMBER:,{ 6q /Y ( PROPOSED USE:r'qa A $ 35.00 INSPECTIoN FEE IS REQUIRED AT T}IE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OI.INER OF THE PROPERTY BE INSPECTED.o S OF PRO TY FOR OFFICE USE ONLY RECEIPT NTMBER: rlDATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: DATE PAID: