HomeMy WebLinkAboutBuilding Fire Damage Report 1995-11-2
CITY OF SPRING~LD
Fire & Life Safety
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
170327 ~/2 010 IS
DA TE : /I - Z ' 0 S
TO: Building Department
FROM: Springfield.Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
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Name of O\~ner
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Type of building
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(Dwelli~g. Store. Warehouse, etc.)
Estimated value of building $
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Estimated loss to building $
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Date of fire
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Location of damage in building
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(Roof, Wall, Exterior, Interior. etc.)
Structural weakness as a result of the fire Jt~,
(Burned rafters. Beams. Joists. etc.)
Additional pertinent information
Electrical Hazard
(Wirinq, Outlets, etc.)
Signed
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