HomeMy WebLinkAboutPermit Fire Damage Report 1994-11-11FD-16\tor \+L
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FIRE DAMA.GE REPORT
OR
ELECTRICAL HAZARD
DATE E
TO:
FR0l'1:
SUBJECT:
Bujlding Department
Springfield Fire DePartment
Structural Damage to Bui 1d'ing
Address or location of bu di ng 4s-
Name of o\^tner
Tyoe of building
(Dwe1 1i ng, Store, I{arehouse ' e tc. )
ltvOEstjmated val ue of bui1di ng
Estimated loss to building $1 J-a o
/-z-qqDate of fire
Location of damage in buiiding €"L(
(Roof, Wa1l, Exterior, inter ior, etc.
Structural weakness as a result of the fire J 0 fr/(
(Burned rafters, Beams, ,-)o ists, etc.
Addi tional perti nent i nformation
Electrical Hazar a A/otr(
(1,,1'iri nq , 0ut I ets, etc. )
u'J tl 2t-q
Sjqned
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