HomeMy WebLinkAboutOccupancy Application 1986-5-27
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,., CITY OF SPRINGFIEL..
Department of Planning and D~opment
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
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OCCUPANCY INSP~ION
APPLIC~)
DATE: ;) /2.7 /r-6
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JOB ADDRESS: 5J'3/ ma: It/" c;-f-
OWNER:~.( r.::.,. 13 ()f'Otl~V''-/.lof'S
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OHNERS ADDRESS)< cj., dlS" E 13-f{ A-..-t.. IEIA.~el1e 6/t 97lfDI
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APPLICANT: Comfd/l/;"tV J//I/;/11e; / cl/;I//e- R/;i(/l1tl1/5 D/I~ ~t;e~pt/1tJ
APPLICANTS ADDRESS: '2.>113/ 11l<t:,v 5'-1-. .._r-t_,ft??7'7?
FOR ACCESS TO PROPERTY -- PLEASE INCLUDE TELEPHONE NUMBER: 77'? -2307
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9'7<;7';(
.PROPOSED USE:_tl..e:fC,(r'f,;t{rYI (0J/./c.. -' J(Pt14/Q/{),II!
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A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
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THIS APPLICATION FORM MUST BE SIGNED BY THE OlillER OF THE PROPERTY TO
BE INSPECTED.
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/~p~ OF PROPERTY O\~ER
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
RECEIPT NUMBER: f3 0 & c.f0~
5-~ 7- ?&
DATE OF REPORT:
DATE PAID:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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CITY OF SPRINGFIELIia .
Department of Planning and De~pment
Building Safety Divislon
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSP~ON
APPLIC~
DATE: 5'" /'2.7 /r-6
I .
JOB ADDRESS: :3;73/ mo: 11/ c;+-
OWNER:X' r.::.,. 13 p"olJJ>...i,.,4,
.
m-mERS ADDRESS)< cj" ..lIS- r=: 13-({ ~~ !E/.{liel1e 61t Q'7JfD I
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APPLICANT: Lomfd/T/;t)tr/III1/;rnq I C///I//c... RTii@1'.~5 DIlIfl..J :[Ge;t/{12VIJ'i'
APPLICANTS ADDRESS: 3%3/ Ifld " N ,5" <f . C;LJ-!1 ~ . 'q? 7' 7"?
._/ . -, .
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 77';1-230/ .
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SSOI""N't1-/!'e ;j .
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'17.Y7X'
PROPOSED USE:_tle:f~r"r/t(rj/ C.J.iiJI../c- .eK(7d'/!/qr'~/1/
I. I .
A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OllliER OF THE PROPERTY TO
BE INSPECTED.
!l ; ~ jf-v11
yCL d~ ~~G;-~
/~P..E OF PROPERTY OHNER .
FOR OFFICE USE ONLY
---------------------------------------------------------------------------
DATE OF INSPECTION:
RECEIPT NUMBER: !3 ~ & C/~~
DATE PAID: 5-dL 7- f?~
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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STRUCTURAL INSPECTION REPORT
JOB ADDRESS
OWNER
ADDRESS
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Mk/i )
DATE
PHONE
5/3()~rA
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TENANT OR OCCUPANT .-f:../)Nl.:4*n)7tY1.J MI.wM--(, e/J-I.J, (' ,
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TYPE OF INSPECTION: HOUSING ~UPANCY COMPLAINT
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FIRE DAMAGE
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Ii~SPECTOR
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