HomeMy WebLinkAboutSpecial Inspection Occupancy 1994-9-16
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OCCUPANCY INSPECTION APPLICATION
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BUILDING DIVISION
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CiTY OF SPRINGFIELD
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ADDRESS OF INSPECTION:
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JOB NUMBER: ad ~
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DATE:
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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:
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APPLICANT'S ADDRESS:
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PROPOSED USE:
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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
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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:
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE:
#f!Ir,(9Y
JOB NUMBER:
91Lt!zf
ADDRESS OF INSPECTION:
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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
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O\JNER'S ADDRESS:
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APPLICANT'S ADDRESS:
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FOR ACCESS TO PROPERTY - TELEPHONE NUMBER:
.--^J<"(l- 'f(., 7(0
================================================================================
PROPOSED USE:
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'-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
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SIGNA\mm OF PROPERTY O\JNER
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FOR OFFICE USE ONLY
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DATE PAID: ~~;z:
DATE OF INSPECTION:
RECEIPT NUMBER:
1~73.s--
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DATE OF REPORT:
DATE OF C~frIFICATE OF COMPLIANCE:
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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
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