HomeMy WebLinkAboutPermit Fire Damage Report 1990-4-23
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S P R r:.C FIELD
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FIRE DEPARTMENT
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: 1- - 2. :5 -10
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
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Address or location of building
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Name of OI.mer
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Type of building
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(Dwe1ling, Store, 14arehouse, etc.)
Estimated value of building $
Estimated loss to building $
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Date of fire
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Location of damage in building wJ{ ~ /;: ~ kzy( A'l~
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(Reof, Wall, Exterlor, Interior, eJ;.{.) /'
Structural weakness as a result of the fire
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(Burned rafters, Beams, Joists, etc.)
Additional pertinent information u~
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Electrical Hazard ~
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(Wirinq, Outlets, etc.)
Signed
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