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HomeMy WebLinkAboutOccupancy Application 1988-1-6 CITY OF SPRINGFIE,- Department of Planning and , ment Building Safety Divis 225 North 5th Street Springfield, Oregon 97477 726-3753 (Bus.) 726-3769 (Insp.) OCCUPANCY INS~ APPLICATION SPRINGFIELD DATE: J _ (., - 8- ;g- " ,1 :::/:F f? 0 () / I JOB ADDRESS: ::J..f). ) / / '-n1 ().. ..:::... /'"0- ~ t..........I OWNER: ... I At'r,}- 9-,,1} rl} U.[.J/Ld__HYL. ~ mVNERS ADD~SS: '(f.. R c-7 '3 7'Y\ ~ ..A.5Jr '11" APPLICANT: <7nc //~.J.A c.,.p~ <;-'0 If"' J)h"'w/Jy1leJ)..[; iPcf:t~~ APPLICANTS ADDRESS: ;:2:1.) <; 1?7.A; ..r FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: 7 ::2,t. -- 7 '7 'd-L . ~ ~o r . \ A. JI' PROPOSED USE: f)" y- (. \.t)...u--.J)~ ,4 '\f'r'1V e -i: S L -e.. -e l-- I I " A $ 35.00 INSPECTION FEE IS REQUIRED, AT THE TIME OF APPLICATION . M-e'5t~ ) ')-rS THIS APPLICATION FORM MUST BE SIGNED BY THE OlmER OF THE PROPERTY TO BE INSPECTED. CItY" ~"l)O6; ~/ ~--d/Jlr'/~ It;O /;IGNATURE OF PROPERTY OIVNER /r' FOR OFFIC USE ONLY " f()7/o( I-Co-f(g DATE OF INSPECTION: DATE OF REPORT: DATE OF CERTIFICATE OF COMPLIANCE: RECEIPT NUMBER: DATE PAID: COMMENTS: