HomeMy WebLinkAboutOccupancy Application 1984-2-29
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CITY OF SPRINGFIELD ~
Department of Public Worlllr
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 725-3759 (Insp.)
I
OCCUPANCY INSPECT~
APPLICATION
"6L\ 01 ~(o
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DATE: February 29, 1984
JOB ADDRESS: 1001 Main Street, Springfield, OR
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OWNER: Snrinofipld Ut.ilitv Board
OHNERS ADDRESS: 1001 Ma in Street
APPLICANT: David Koski
APPLICANTS ADDRESS:
1001 Main Street
FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: David Koski -
746-8451 ext, 358
PROPOSED USE: Convert storaqe room to spray paint booth
A $30.00 INSPECTION FEE IS REQUIRED, AT THE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE O~mER OF THE PROPERTY TO
BE INSPECTED.
D';';; )jvh, 't;; '.~M, rf,1i ~ &J
SIGNATURE OF PROP TY ClI.JNER;1 ,
FOR OFFICE USE ONLY
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DATE OF INSPECTION:
RECEIPT N~BlR: Lo~4C1t 1/
DATE PAID:(oUb . 2/1/ BeLL-
DATE OF REPORT:
DATE OF CERTIFICATE OF CONPLIANCE:
COMHENTS: