HomeMy WebLinkAboutOccupancy Application 1996-1-31
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OCCUPANCY INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING DIVISION
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DATE: _T:".....,.'~~y ?~ _ :!.??h
JOB NUMBER: Q/9D1-C/0
ADDRESS OF ~NSPECTION; 525 Mill Street (Quonset #2)
OWNER: Sorinafield School District #19
PHONE NUMBER: 726-3254
OWNER'S ADDRESS: 525 Mill Street, Springfield OR 97477-4598
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APPLICANT: --Bl::1.'''''~ .~mnln~. ~r'ri n.g.fip.~d ,School District
APPLICANT'S ADDRESS: 525 Mill Street, Springfield OR 97477-4598
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: (541) 726-3254
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PROPOSED U~E: Office and meetina soace.
A $35.00 INSPECTION FEE IS REQUIRED AT THE T~ME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
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SIGLIIJUUKt:/ (JI;" l'KOPERTY O)iNER
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FOR OFFICE USE ONLY
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DATE PAID;
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RECEIPT NUMBER: 0 'LOU>D 2.
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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