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HomeMy WebLinkAboutPermit Fire Damage Report 1995-5-29 . 3b At-e " q 50?f7L-/ , ~ ---- --/7~ /?c/q 2> /. cl:J - ..) c' FIRE D~AGE REPORT OR ELECTRICAL HAZARD DATE: 5"/2<1 (q) PROM: Fire Department SUBJECT: Structural Damage to Building )f TO: Building Department Address or location of building 4100 bie<-k Mqi", c;+- . (. sic/.( (Q(N}S fro", I=;n\ d.~iV( , Name of owner U"k""j""" Type of building (A~+Pu:ld:,,'j / '" 'Ira1'" (Dwelling, Store, warehouse, etc.) Estimated value of building $ '2'0); / Estimated loss to building $ fODr> Date of fire 5/2'1 (q, Location of damage in bu ild ing f2c<.h~(\ d "L..)\ 1'1/e. (' t 1<1 J'r cJ <;c> ~ extc-"<,; ~ l,,_ (Roof, Wall,! Exterior, Interior, etc.) Structural weakness as a result of fire Wall, ,\- ~n~~ '...ve.. l:::p.roul (Burned rafters, Beams, Joists, etc.) Additional pertinent information \;)c ",,:11 I?- CvJ'<:~;n. dc,,,,,,,(i~io^ ( -' 1+ " ..." '" bA~~,,~d III '" ,:~ QvX: < ,~t- 'p.o, \~\:"" J -Ihro",h F:N" f\'\a.r,1na\ fJ:) /L(J C\.,..t-I, Electrical Hazard (Wiring, Outlets, etc.) Signed CJi'1M allt ll'-tOrw<-zO pGJ C:::, ""',!'i.. C( ~