HomeMy WebLinkAboutSpecial Inspection Occupancy 1989-4-3
CITY OF SPRINGfIELD
Department of Planning and Dev.ment
Building Safety Divis
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPE~N
APPLICATION
SPRINGFIELD
DATE:
1f-3-~r
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JOB ADDRESS:
5415-5531 Main Street. Sorinafield
OWNER:
Income Prooertv Manaaement Co_
mmERS ADDRESS:
1111 Pearl Street, Eugene, Oregon 97401
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APPLICANT:
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 345-2361
PROPOSED USE: Su'Bl>Jc...y SAw~~; C'.-- ~1::<;.-I-..)~rrV"1'
A $ 35.00 INSPECTION FEE IS REQUIRED AT T}lli TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OHNER OF THE PROPERTY TO
BE INSPECTED,
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OFFICE USE ONLY ~,"
FOR
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DATE OF INSPECTION:
RECEIPT NUMBER: /pY01?
DATE PAID: 7"-?~5_
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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