HomeMy WebLinkAboutOccupancy Application 1987-9-1
'CITY OF SPRINGFIELDA
Departm~pt of Planning and Dev~pment
'~Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPE~ON
APPLICATION
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DATE: ~~J2e,~ .::1, I~PJI
JOB ADDRESS: -L/03+ rv1tU.#l, ~t10hdJ
OWNER: R~ u.;e~~
mVNERS ADDRESS,( ho<;-0vtt(;,s ')..L]031' ~~
,APPLICANT: ~Jf1~J!: K,@,.JtAIfVL_; '~
, APPLICANTS ADDRESS: A?JS Y:z. E. 10-11-.. ~6, 'i.u.a,f' ~ '
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: &.7Y)-
*t101047
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} PROPOSED USE: Jijj~A<'/..~DY\..- bi1St~c,~
A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION '
THIS APPLICATION FORM MUST BE SIGNED BY THE O,mER OF THE PROPERTY TO
BE INSPECTED.
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SIGNATUP~ OF PROPERTY OHNER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
RECEIPT NUMBER: ' / D I ~ 9
DATE PAID: Ij- 3 - t' 1
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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DATE:_ ~fHjlYLl2M .J.; 1~8l CoI
JOB ADDRESS: -403+ JV1tu,.vl, :3p;MYl0RdJ
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OWNER: R~ LJ2e,~Cf<Z
millERS ADDRESS,( htA<;V,1tsS ')--4D3-t r'1~
APPLICANT: <0 Jt1~,R k~~rrn__; ~
APPLICANTS ADDRESS: 435 Yz. e.. 10-/1--.. ~6, fufJ..f ~ '
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FOR ACCESS TO PROPERTY - - PLEASE INCLUDE TELEPHONE NUMBER: if,' F') -
CITY OF SPRINGFIELD
Departme'l)t of Planning and Dev.pment
B u itl din g Sa f e ty D i vis 1 0 n
~;..-'
225 No~th 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPE~N
APPLICATION
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PROPOSED USE:
SPRINGFIELD
*6') 01047
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A $ 3~INSPECTION FEE IS REQUIRED AT THE TIME
~ OF APPLICATION '
THIS APPLICATION FORM MUST BE SIGNED BY THE OvlliER OF THE PROPERTY TO
BE INSPECTED.
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SIGNATURE OF PROPERTY OvillER
FOR OFFICE USE ONLY
RECEIPT NUMBER: / D I:J- 9
0/- 3 ~ f 1
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
DATE PAID:
COMMENTS: