HomeMy WebLinkAboutSpecial Inspection Occupancy 1989-4-3 (2)
CITY OF SPRINGFIELD
Department of Planning and a~lopment
Building Safety D;~on
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY IN~TION
APPLICATION
SPRINGFIELD
DATE:
1f-3-~i
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JOB ADDRESS:
Oi-lNER:
Oi-lNERS ADDRESS:
APPLICANT:
5415-5531 Main Street. Sorinafie1d
Income Prooertv Manaaement'Co.
1111 Pearl Street, Eugene, Oregon
97401 .... A
~~
APPLICANTS ADDRESS:
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 345-2361
PROPOSED USE: 5u'BW6..V SA't0~vJ; C~ ~~'i.-{..JR,rrV1-
,
A $ 35.00 INSPECTION FEE IS REQUIRED AT Trill TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OllliER OF THE PROPERTY 'TO
BE INSPECTED.
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Yf1~;; ~..Ju
FOR OFFICE USE ONLY ~ I
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DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
RECEIPT NUMBER: J ?-4G Y
DATE PAID: 4/0.. ixq
(J I .
COMMENTS: