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HomeMy WebLinkAboutOccupancy Application 1990-1-2 CITY OF SPRINGFIELD ' Department of Planning and De~pment Building Safety Divis~n 225 North 5th Street Springfield, Oregon 97477 726-3753 (Bus.) 726-3769 (Insp.) OCCUPANCY INSPE~N APPLICATION I--Z-~O 1750 111~ OWNER: ?~..... t K (~de.L L millERS ADDRESS: Y[f~ 2. A-p.pLQ... -Iy~-t. APPLICANT: .:{/t),.",- L. K' ~4e.Ll APPLICANTS ADDRESS: 1'10 ( MayJ,..4..:f- JOB ADDRESS: Sf ~ SPRINGFIELD ~ @O\ 13E'~4- q rx:J:Y) DATE: r!JV , Eu....~eAJe.o~ e;7YOJ" " FOR ACCESS TO PROPERTY--PLEASE INCLUDE ~7 s(Jl")~/~c.J. , , - TELEPHONE NUMBER: 7 2 ~ -6,~ /" PROPOSED USE :~~. s..\~ 0 A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION . THIS APPLICATION FORM MUST BE SIGNED BY THE OI-1NER OF THE PROPERTY TO BE INSPECTED. k SIGNATURE OF PROPERTY O\~ER FOR OFFICE USE ONLY DATE OF INSPECTION: RECEIPT NUMBER: I Z:SCo04 DATE PAID: J -cJ -qc) DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: COMMENTS: