HomeMy WebLinkAboutSpecial Inspection Occupancy 1993-4-2
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OCCUPANCY INSPECTION APPLICATION
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CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: ~ - ~ 0 - q 3. . JOB NUMBER: 0{?;i) :::s-;
ADDRESS OF INSPECTION: lJ. LO. ('e.p+roJ 58t-~ s+ '\-- me- k-e.nz..jf' I~wy
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OIlNER: .4.lbp.>:tsons 5fJf\D ~~n_, {\J>HONE NUMBER: 208-38'i-MiCl5
OIlNER'S ADDRESS: 250 Park Center Blvd., Boise, Idaho 83726 Attention: Dewev Bills
APPLICANT: 'Our I?.....+-.. WCu-j"'''''' ~
APPLICANT'S ADDRESS, 158/ s.,u+h S,^_ 18 ~L,.,"hti\;^ Or g74'9T
FOR ACCESS TO PROPERTY -TELEPHONE NUMBER: \1,+-t> ltu.l.e"-- LJ5Cj C)Q15 /45Ct 153D
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PROPOSED USE:
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A $35,00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
i~~PLICATION FORM MUS~ BE SIGNED BY THE OIlNER OF THE PROPERTY TO BE
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SIGNATURE O{ PROPERTY OIiNER Harry N. Ruth Agent for the Owner
AMACHER & CO., 44 West Broadway, St. 200, Eugene, Or 97401
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FOR OFFICE USE ONLY
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DATE PAID:
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS: