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( ~