HomeMy WebLinkAboutMiscellaneous Fire Damage Report 2005-9-8
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FD-016
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
TO:
Building Department
Date:
FROM:
Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of Owner
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Type of Building
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(Dwelling, Store, Warehouse, etc.)
Estimated value of building $
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Estimated loss to building $
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Date of fire
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Location of damage to building
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(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire
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(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
Electrical Hazard'
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(Wiring, Outlets, etc.)
CC:
Signed
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V:\FD]ORMSIFD-016 FIRE DAMAGE REPORT.doc
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