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HomeMy WebLinkAboutOccupancy Application 1984-2-29 ... ',,! 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 - DATE: February 29, 1984 JOB ADDRESS: 1001 Main Street, Springfield, OR ~ 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 --------------------------------------------------------------------------- DATE OF INSPECTION: RECEIPT N~BlR: Lo~4C1t 1/ DATE PAID:(oUb . 2/1/ BeLL- DATE OF REPORT: DATE OF CERTIFICATE OF CONPLIANCE: COMHENTS: