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HomeMy WebLinkAboutPermit Fire Damage Report 1980-11-28 , J ~~&~ . , ~4~~ FIJ-16 . 011.-'" .:--.. !/~.uN;) / ~\ .--------... FIRE DJlJ1AGE REPORT OR ELECTRICAL HAZARD b DATE: l!-=-~~ - 6<> TO: Building Department FR0I1: Springfield Fire Department SUBJECT: Structural Damage to Building * . Address or location of building 1012 ~1\~lpJ ~r, i! 23 Name of owner ()~ IENE f'hElos <;oym.jV t==leI CaQrrl Type of bui lding MoTEl - npnrzr/ol1ENT (Dwelling, Store, Warehouse. etc.) "~ . Estimated value of building $ &::i:f)- Estimated loss to building $ 1 [)(X) - Date of fire 11- "Z.~-;t,u Location of damage in building LIUlnS...07lm al2Ea o1\d ~trl1\1 FI.../Wlj , Ol1T'5If)F '\ - (Roof. Wall. Exterior, Interior. etc.) Structural weakness as a result'of the fire "-lONE i' (Burned rafters, Beams. Joists, etc.) '., Additional pertinent information al+hou3h -\+11= ~IYE c..ClU';:a:l S.lb- NI~Ic..Ot-.lr d"'~M~G - l~ 11B.~ YY'OS~' '5.110E"f2.bl(lal. ,I-' t-Ian.l12F -rhr= hu,lri,,/..tj was n\Y~~'Y\ a nnry( SiaTf'.. Electrical Hazard THH2fO f\~p;arz.s::l 1D bE IoJDMETFI2S CD LDWT2d ~ e:;IECT121(Cl1 LurWC/-.IT 1"-l1O TIt(; aOT. - L wDuld (Wirin~, Outlets, etc.) ....... ./ cc: S i g ned l L.U +...tA c,..v-:5 ClV'-- o Au.; eopl-. r "r.\.:- " . . ..':;:~ .... ') " . -: em MaTE nJaT a SIS nlblCCll'\l l.=1E'(iT<'lca( LocaTlDt-.j; ~nd Sh6Ulcl be REtJ=rzEd in be:;bCl2E occ.up~Y\c~ [$ ,pEI2M.lCm~. c......~. . .' '. ',,' " haj912d 8Clsr :. ntt.5 -f-hG' El=-I ulcaf 1l"\"SpG'C/Zlf