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HomeMy WebLinkAboutOccupancy Application 1995-7-14 i~ .....~.. . . OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION ::::~==========:;=~=;~~=~=~=:;==========================:::=::::::~==l:\~~(:) ADDRESS OF INSPECTION: '::, E; 'Sc:;, ~l'.- ,,'. ~'" I ') ~ l2..~'" IS ~ \ ~'-\) t-. tL ., I '-('1 '( O\INER: '3 \ 'lV'\ C:,R~E~<;t.. PHONE NUMBER: 310Cl S 71 -') 73( '\~(.,Io() Ol/NER'S ADDRESS: \10\ d.. COI..-'V......~\<'\ ":,"\ ,\J....."'c:."''-.l~tn.... \.N "" APPLICANT: C:.<:l~"'''N :r-. W"""-'<:.~f','" ~-"o.!''''-, "'nn -'" ;) v..... , ,;) , ,~, "'1;:,'- \ ""'-:I) I:).(/.... q') '-+11 APPLICANT'S ADDRESS: \. '5" s-o FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: <:;'o(/...Q~..J ~" l~t;,;-c:~T7 G. ================================================================================ PROPOSED USE: ~ \J '),.1"> c.....a... '-0",,- R~~~\,- "'''''' '-- '<-.Ii. A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION THIS APPLICATION FORM MUST BE SIGNED BY THE OI/NER OF THE PROPERTY TO BE ~'::;~~~;:~_::_:::::::~:::::_-----~':_'-::_--,,--":::~---------------------~ FOR OFFICE USE ONLY -------------------------------------------------------------------------------- DATE PAID: Y) . \'1 ,QS RECEIPT NUMBER: DATE OF REPORT: \ ~?f1 DATE OF INSPECTION: DATE OF CERTIFICATE OF COMPLIANCE: ....~..~ COMMENTS: .... 1-01-1995 2,04At.' FROt.1 .,,, 1," "'".'~. f.. .1....' I,' . P.2 . ':-:. ,....;::.... , , OCCUPANCY INSPECTION APPLICATION CITY OF SPRINGFIELD BUILDING DIVISION ~~.==~~C~;=S5_=~~~;~~~:=~~~~~==~~~~~rz~=~=~~~~;~~~~~~~~~~=~~~~=ca~~~=~Q~~~m=~~~~s .' DATE: -L:-..l'::~--=- <\ <; __._......___.______ JOB NUMBER: ADDRess OF INSPECTION: '~b'S<:) ",^"f'. "" ~"'\ 1<''' (7_~"" 6~ \ t.\;.~ t-,Il- ,"1"'11.{ i~ O\JNER: '_'S \ "l'<"\ (;;,RLEf\~ PHONE NUMBER: ~1oC) S n -') i '" ~ Iolo() I O\JNER'S ADDRESS' 'Io\'i).. (',0\. v........ ~ \f\ ...,-, \ ~~",c~-J~t~ \J:).(', APPLICANT, \:.....,<::).$2. ~",(-l ~. '\N"'''-~t'''I'\(>,.r-' l'._""/"'_, ~...^ - ;) y ~"" ;" <<.. \ (oJ",,'<" \ \::,"""~ c:;:,.oll~<:>",,.J 04-- ~ '"1 ,,+ ") '} 1;>'~-.I:)"3'1~. APPLICM,T'S ADDRESS: \~GO FOR ACCESS TO PROpERTY - TELEPHONE NUMBER: ....... T\." , ~c~~=~g~=~==c~~~s~;e~';~,~~~~~;~~~~~:==:~~r~=t!~~~~~~~c~e=~~=~~=~~~eacc~~~=~.g~~=~~~ PROPOSED USE: '-'\'::1 'to;) c.. I'\(t... ~<:>" _ ~"'- "f'\,,\... '31\.~~<:;' _.-~-_... ,.~._._.,*"'_.__..,..-..__.--~.,- A S3S, 00 INSPECTION FEl:: IS REQUIRED lIT Till:: 'J'l11E OF APPLICATION . i:;;~ON FONa~GNE:JHf OWN" OP '"' YSiG~ E Of ~~'f OliN ~ ei PROPERTY TO BE ___ ___~_____- _....~__. .___ ... .... ~ _.. _ _. _ .. _. .. r __._. ~ .... - .'. . ~. -.. ~... --....--....- -----....----- ---~- ----~ FOR OFFICE USE ONLY -----------------..---.-. --...---..----.------.-.--.---------------------------------- DATE PAID: RECElPT NUMBER: DATE OF REPORT: DATE OF INSPECTION I ,DATE OF CERT1FlCATE OF COMPLIANCE: COMMEt\TS: .... -....-..... ....--... ....-... -... .~._.._------- -....---. ...........--.----... ---