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HomeMy WebLinkAboutSpecial Inspection Occupancy 1994-9-16 , ,,- . . OCCUPANCY INSPECTION APPLICATION rf^D2& BUILDING DIVISION '~, CiTY OF SPRINGFIELD -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- ADDRESS OF INSPECTION: Lf 8b h'1~..l(__cI JOB NUMBER: ad ~ /../-r/ ~T DATE: , "1(~/9Y OVNER: ~Af;I.. VA/IOy~. J-.L.. C. PHONE NUMBER: /C//-'I('76 OYNER'S ADD;ESS: " (t3(a.l:e f/.vfr,y/AIRIh111t(4) (,37 B s;,: 5p""'(ct,Of(, Cf?'TII APPLICANT: 13 (c-..t:e H-.s. +,5..1 FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: '/<,(1- '-f~ ,(0 APPLICANT'S ADDRESS: ~ v--e... ================================================================================ PROPOSED USE: '\:> '" 'I C ...... ~ -h-. I '-t S- c. r....,.(J~o.J . A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OVNER OF THE PROPERTY TO BE ~P? \ - . \- -.r.. ~ ......._ SIGNATURl:: OF PROPERTY OYNER FOR OFFICE USE ONLY DATE PAID: ~~~ DATE OF INSPECTION: RECEIPT NUMBER: 1.f.73S" DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: ,. . . OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION ================================================================================ DATE: #f!Ir,(9Y JOB NUMBER: 91Lt!zf ADDRESS OF INSPECTION: 4fSP h1~IIa...cf OIINER: G~/~ r/...t1e.ov p.,;-. 1-. L. (". PHONE NUMBER: v (t3/a.1:f! fj.:vfr,y/""k /hll/~) Cr37 6 5T: 5p~(cf, Off, <t7'f71 APPLICANT: 131 0..-1=.:. ~-\Y..I "XII-C{' 76 , O\JNER'S ADDRESS: " APPLICANT'S ADDRESS: ~~ FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: .--^J<"(l- 'f(., 7(0 ================================================================================ PROPOSED USE: Vo.'/C ......~ I J:.. '-t S- c..l...,.(cD~oJ . A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST llE SIGNED llY THE O\JNER OF THE PROPERTY TO llE ~.')-~ \ -~ SIGNA\mm OF PROPERTY O\JNER --------------------------------------~------------------------------------------ FOR OFFICE USE ONLY -------------------------------------------------------------------------------- DATE PAID: ~~;z: DATE OF INSPECTION: RECEIPT NUMBER: 1~73.s-- .' DATE OF REPORT: DATE OF C~frIFICATE OF COMPLIANCE: - . --1\ .r\.--~"-~~::~;;..-~~, "-~-2~~~\ 637 B STREET 'i'/II 19 , t , SPRINGFIELD, OR 97477 t ~ .I PAYTOll'" C-,;...". JJ 7~r.PcI. -- j $ J>" , ORDER or I 17 0"/ ~DOllARS ~\ T iv-"+1 {r;" ~Y f ' t90 ~:\ Cf NrfNN!!,,.!-:g8~NIC ~ ----==~... , .> I t.'tJODlI:lUIN8,~0I11:00NII74'O - "'""--~' M' ~o 1lOJC.IIo6O,l:"" - . d~ 1-- '/:2t.,l~' '-:'.__.______. w____. ____ ,--.------"-- --..--. ...--. __..n' -.. -. L~:;'O ::~=~~~---~c--~-~.. .=-~'- _____--.--o,.._.....,~ . -