HomeMy WebLinkAboutPermit Occupancy 1996-06-11sPFlla\rrrtFiELc,
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CITY OT SPRINGFIEU)
225 FII:TTI STREIT
5 P t:11 NG i: I EI-L), OR 97 477
(s4t) 726-37ss
FAX (s41) 726-s6qe
OCCUPA}.ICY TNSPEC'TION APPLICATION
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BUII,DING DIYISION
("7G JOB NUMBER:Q0oz[/DATE:
ADDRESS OF INSPECTION:z+4 /U. 31 +h
OIJNER:,€st<rl Rvnrr,''-rr
OI.INER' S ADDRESS:
PHONE NUMBER:4b-0tz_5
C'TY OF SPR OREGO'V
APPLICANT:nil>/'e-il 4 ngzfsb>
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APPLICANT'S ADDRESS:2
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
PROPOSED USE:4v*D B
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THIS APPLI
INSPECTED.
A $gS.OO INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
CATION FORM MUST BE SIGNED BY THE OI.INER OF THE PROPERTY TO BE
FOR OFFICE USE ONLI
DATE PAID:-// -RECEIPT NUHBER:
DATE OF REPORT:DATE OF INSPECTION:
DATE OF cgntlrrceTE OF COMPLIANCE:
COMMENTS:
PROPOSED FLOOR PLAN REQUIRED AT TIME OF AiifiGATIoN
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