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HomeMy WebLinkAboutOccupancy Application 1990-1-9 CITY OF SPRINGFIELD Department of Planning and Deve.- ent Building Safety Divisi 225 North 5th Street Springfield, Oregon 97477 726-3753 (Bus.) 726-3769 (Insp.) OCCUPANCY INSPEC~ APPLICATION q I Cf)(JO DATE: /'9/90 JOB ADDRESS: J J 2c Jt,., ........--:... lJ-.-.. OWNER: cf:,- -::, \..Lc,,-L.J ,. mVNERS ADDRESS,: 5' S- SL4~r 1_"....,t'J APPLICANT: ~~ APPLICANTS ADDRESS: ,~ FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: F:..~( A--t; A.-.!:"2. ~~-I'f-' PROPOSED USE: -h. L };.'''-o lKlJJ . it: $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION A ~~ '~I " ~ J</-? - ""V99 THIS APPLICATION FORM MUST BE SIGNED BY THE ,OvlliER OF THE PROPERTY TO BE INSPECTED, ~ ----- ~ SIGNATURE 6FlPROPERTY OWNER FOR OFFICE USE ONLY - - - - - -- - - - - - - -- - - - - - - - - - - - -- -- - - - - - - - - - - -- - - - - - -'- - -- - -- - -- - - - - - - - - -A - - - -- DATE OF INSPECTION: ,. \ \ ..y \ . \4 .q I RECEIPT NUMBER: / q()4 '7 '1-q-QI DATE OF REPORT: DATE PAID: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: ~~