HomeMy WebLinkAboutOccupancy Application 1983-6-14
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OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
BUILDING DEPARTMENT
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DATE: fl:'dI ),1/,'/98? ' ,
JOB ADDRESS: -15- tJ s- m A J ..J1/
OI.JNER: ).//-J-r2tJ)/ '/ ,0/-),1/ /...'l
OWNERS ADDRESS: ///15 ,( /) , .7 yE. t?/A-t! ~_
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NUMBER OF UNITS:
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APPLICANT:
APPLICANTS ADDRESS:
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FOR ACCESS TO PROPERTY -'PLEASE INCLUDE TELEPHONE NUMBER:
A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME
.' OF APPLICATION
THIS APPLICATION FOID1~ruST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED.
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FOR OFFICE USE ONLY-c.'--- .'._._.__
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DATE OF INSPECTION:6-/t>-'83 DATE OF CERT. OF COMPLIANCE:
DATE OF REPORT: RECEIPT NUMBER: I 0 I ()R 1
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83\'1'11
OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
DATE: ri~ ",/I II/,/c;8? '
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JOB ADDRESS: 3~-()S m-a/./I/
OWNER: J-JA-rZtJJ/'/ ,{}A II is
OWNERS ADDRESS: J // If ,)' /) , .? Y E. t?/A-,( -.e.
BUILDING DEPARTMENT
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, NUMBER OF UNITS: .' / '
APPLICANT:
APPLICANTS ADDRESS:
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FOR ACCESS TO PROPERTY -'PLEASE INCLUDE TELEPHONE NUMBER:
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A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FOm1MUST BE SIGNED BY THE OWNER 'OF THE PROPERTY TO BE
INSPECTED.
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"'SI@ATURE OF PRUPERTY OWNER
________________________fQ~_Qff!gg_Y~g_Q~1Y________________~~~~~~~~~~~~=~=
DATE OF INSPECTION:
DATE OF CERT. OF COMPLIANCE:
RECEIPT NUMBER: to I ()R 1
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DATE OF REPORT:
REMARKS:
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83\'Fll
OCCUPANCY INSPECTION APPLICATION
EXISTING BUILDINGS
CITY OF SPRINGFIELD
DATE: rZ~ ../J, jujc;8? '
I ., /, ,
JOB ADDRESS: -1.5- (J S- m A / .J//
OWNER: )/./HZtJ)/ / IJA- iI /~)
OWNERS ADDRESS: J//?5 .( /) , .7 yB ?/A-c. ~
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BUILDING DEPARTMENT
, NUMBER OF UNITS: I
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APPLICANT:
APPLICANTS ADDRESS:
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FOR ACCESS TO PROPERTY -'PLEASE INCLUDE TELEPHONE NUMBER:
,
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A $24.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FOro1~ruST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED.
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________________________IQ~_Q~I!g~_Q~~_Q~~y____________~~~_~~~~~~_________
DATE OF INSPECTION:
DATE OF REPORT:
REMARKS:
DATE OF CERT. OF COMPLIANCE:
RECEIPT NUMBER: 10 I {'FA 1
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