HomeMy WebLinkAboutOccupancy Application 1984-3-21
CITY OF SPRINGFIEL~
Department of Public h ~ s
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
APPLICATION
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DATE: ~ - 7 ( -5((./ . .". . <f^- 3/'d'v>Vt:J?
JOB ADDRESS: 2r '67 o(~{u~ s.--+. -t+i;7
OWNER: "-r:u..,,,,,,? /)rc-p-e,:j.../ /1IJ~-"':_j.R-~'f7I'W..J (", / fk;1//A:Is -Iz,,,, C'1._j)~/\
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mVNERS ADDRESS: /1 II ?.~cvJl.sJ- .!'UIC4>-P' ~ 97'177
APPLICANT: fY) 'I c:1 "f C1 AV-1
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APPLICANTS ADDRESS: 0:;;"2. La (()e "lr\
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE
S..o-r !r;i.
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TELEPHONE NUMBER:
7C/7' (,3~
711- 0357
PROPOSED USE: /nl'Yl m '\ <;" <: v Li
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WC...--( k a<., <;'-f'
A $30.00 INSPECTION FEE IS REQUIRED AT T}lli TIME
OF APPLICATION
THIS .6..PPLJ.CATIC!'1 FQPJ1 HUST BE S:!:CNED E'! THE o~'mE~ OF THE PItOPERTY T8
BE INSPECTED.
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SIGNATURE OF PROP{R;yVOlVNER -
FOR OFFICE USE ONLY
---------------------------------------------------------------------------
DATE OF INSPECTION:
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RECEIPT NUMBER: lo'LLo2:f7
DATE PAID:l.ffi(\]\ , 2...L.~B4/1 dlffiill!;;'~
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DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
CO}1MENTS: ;i)/.Jn,t,,:Oj AhulJ /H~/I. oK. .
,)j: I._n 7.",~qo / ,,/~ ~
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CITY OF SPRINGFIEL. '
Department of Public \ ks
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
.
OCCUPANCY INSPECTION
APPLICATION
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(..J,Jt~wJ ~ ~-C-U):... M ~
DATE: ~ - 7. ( -~ .. . ", .' \ O"'rv 3/~~\'b? j
JOB ADDRESS: 2'7 't7 O~ S:f-. -f:t~
OWNER: :r;~.A'N'U (l~ Mlj~?O?V'4J (...." /!.&r:?Ais -hy c>Wl~
m-mERS ADDRESS: /J / I ?~C<A..fl sJ- t:"'-;1&?4>-P- , ~ Cj 7</77
APPLICANT: /Y) ]r.- (1 re Cj pfV'-f V
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APPLICANTS ADDRESS: ~-ZLo (YIe'lir, 5p~I(J
I
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THIS APPLJ.CATIC!'! FGP11 MUST BE SICNED B'! THE O~'7NErr OF THE PROPERTY TO
BE INSPECTED.
-L~g~Uk,j-~f ~
SIGNATURE OF PRopfRTYllm-mER -
FOR OFFICE USE ONLY
---------------------------------------------------------------------------
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
RECEIPT NUMBER: lo'lLoa7 I
DATE PAID:,J'{\M . t.'l.~ e4/1 dJJA~ ·
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