HomeMy WebLinkAboutOccupancy Application 1988-3-25 (2)
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iJ ", CITY OF SPRINGFIEL:t
Depart~ent of Planning and De pment
Building Safety Divi .
225 North 5th Street
Springfield, Oregon 97477 .
726-3753 (Bus.) 726-3769 (Insp.)
OCCUPANCY INSPE~N
APPLICATION
DATE: "3 ~,;7 5'- &-'?5-
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JOB ADDRESS: .&?J::9. J / ~ ~ ~....
OWNER: (J/?/R. *?Y~ J;.,&.A. J'?~
mmERS ~~S~: '- ~ '9 ~ ~--n ("~'._ ~
APPLICAi-n:l~~~- 1lt?'.e4-<./d H4& /H"<c///'~~'<
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. APPLICANTS ADDRESS: 22/1 .#/.4-/4/
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER:
117'Yi./6- 7;7(. -7 / ,.--~
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PROPOSED .USE:
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A $ 35.00 INSPECTION FEE IS REQUIRED AT nlE TIME
OF APPLICATION
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THIS APPLICATION FORM MUST BE SIGNED BY THE mINER OF THE
BE. INSPECTED.
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l~dN~iuRE OF PROPERTY OlfNER .
FOR OFF ~ USE ONLY
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DATE OF INSPECTION:
RECEIPT NUMBER: III 9q
DATE PAID: 3-.,;).S -x--R"
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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Planning & Development
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OF SPRINGFIELD
Job.
No.
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OFFICE OF COMMUNITY AND ECONOMIC DEVELOPMENT
225 North 5th Street
Date
Building Division
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JOB ADDRESS
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CALL FOR REINSPECTION
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INSPECTION 726-3769 ---- INFORMATION: 726-3753
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..Job' Number
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CITY OF SPRINGFIELD
, BUILDING DIVISION . 346 MAIN STREET .' . 726-3753
WE HAVE INSPECTED THE ELECrRICAlWlRlNG AND EQUIPMENT INSTALLED BY YOU AT THE PREMISES NAMED HEREIN AND SUBMIT
THIS REPORT FOR YOUR RECORDS. .
TO
~'11 07-cP 0
INSpeCToR
DATE
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OWNER OR .
. TENANT
LOcA liON OF
JOB -
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o A PERMIT IS REQUIRED
'0 H.EAT CABLE APPROVED FOR COVER
0. UNDERGROUND APPROVED FOR COVER
0. WIRING COVERED WITHOUT INSPECTION 0. CONDUIT SYSTEM .APPROVED FOR COVER
0. DUE TO THESE PREMISES BBNG LOCKED AN 11'o.>r"'-1I0N COUlD NOT BE MADE
0. DUE TO NO ONE HOME AN INSPECrON COULD NOT BE MADE
0. WIRING APPROVED FOR COVERJN7 EXCEPT THE FOUOWlNG.'. .'.
n, H t~ "" .,rL-;" 0.." \,.s- 4 ~~ ~'! ~~<:_'.~i.t;ta}:~+ ~ 1C
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o WIRING APPROVED FOR COVER .
0. APPROVED FOR SERVICE
0. WIRING INCOMPlETE
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CITY OF SPRINGFIELD
Dep.arjjment of Planning and Dev.ment
, Building Safety Divis..
225 North 5th Street
Springfield, Oregon 97477 .
726-3753 (Bus.) 726-3769 (Insp.)
OCC~PANCY INSPE~
APPLICATION
DATE: '3 r d-:J- 5?CX--
7L1CJ.~ ItJ/JO'tfgOc?00
JOB ADDRESS: .=-J::-9. II ~ /A0~ ~.....
OWNER: ~ ~ ff. ~ ~~ +..le....... p .?J-'/-':""'"
OHNERS ~RESS: L a '9 ~ ~-r"\ /'~._ ......8'
APPLICANT:a~~'- /l~.e4A/d ~& 1H4:;///,~~,< /h~)
APPLICANTS ADDRESS: 22// .#/.4/4./
FOR ACCESS TO PROPERTY--PLEASE INCLUDE
~"lj6-
TELEPHONE NUMBER:
PROPOSED .USE:
-7.J~ -7 / ,--~
12 .J/, A?e';I1-47,Q
!..AJtd.tto 1/lD.
/?!~.~~.
A $ 35.00 INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
'...--'.....
.;....,
THIS APPLICATION FORM MUST
BE.. INSPECTED.
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BE SIGNED BY THE OHNER OF THE
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PROPERTy;:rro.",. .
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f}/f/ ,~r4rTL
;8~GNAiURE OF PROPERTY OlVNER
{ USE ONLY
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FOR OFF
----------------------------- ---------------------------------------------
DATE- OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF C0l1PLIANCE:
COMMENTS:
RECEIPT NUMBER: 1119q
DATE PAID: 3-~s -x--R>-