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HomeMy WebLinkAboutOccupancy Application 1983-10-7 CITY OF SPRINGFIELD'" Department of Public W~s Building Safety Division 225 North 5th Street Springfield, Oregon 97477 726-3753 (Bus.) 726-3769 (Insp.) OCCUPANCY INSPE~N APPLICATION SPRINGFIELD 8~\\q DATE: /0-7- ~-3 JOB ADDRESS: 4/01> f '-/11:1- '-777,."',, .2.J. ---- ~ 4.0; /nlllR. q 7'177 OWNER: 1=R"M.R .'7f,1~r OHNERS ADDRESS: 5,?J ~ru__ it .toi/,.! (),('Q7'i77 '. ' 't; APPLICANT: ~.',... ~ ~LbiZ.Jt..l_ {:rucU.s APPLICANTS ADDRESS: 4..55'-1 {!Q..n\..d.U~ Sf- ~CJI.{,J oR. q 7,/77 .(/ FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: ~: 7:J./':i;l./.;l- ol2-1 ~2.t ~ 7'/6?50b PROPOSED USE:. LI. <:, ~ (!u..R., 'z'o-f f Oth(-.", A $30.00 INSPECTION FEE IS REQUIRED, AT THE TIME OF APPLICATION ' .f ,,=-'IL !&( '" THIS APPLICATION FORM MUST BE BE INSPECTED. SIGNED BY THE OvrnER OF THE PROPERTY TO / .' --) i\-h ~1 \'(\. ~~ D+ SIGNATUP~ OF PROPERTY ~ FOR OFFICE USE ONLY --------------------------------------------------------------------------- DATE OF INSPECTION:\O- \ ~ - R~ DATE OF REPORT: RECEIPT NUMBER: \.o\~ \ U \()-\ D ~?;~ DATE PAID: DATE OF CERTIFICATE OF COMPLIANCE: ... _ ~ \~ ~~~"" COMMENTS: ,e" \.':\.. J~ ~C?..(" ~'C'lb) ~ \. '\J\.e A.. '\.\. , ~e-\."'r-:)~V ~NV'\. ('\~..:\,;'e C"'\~ \.~ '\.\' '\~~('\-\C""\\'"' , \()-'L~-~~'\. \ " -)