HomeMy WebLinkAboutBuilding Correspondence 1988-3-8
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RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIOEO-
NOT FOR INTERNATIONAL MAIL
(See Reverse)'
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CERTIAED FEE
I SPECIAL DELlVEAY
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. FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
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DATE: I1Mu.t.. (, IQrrr
TO: Building Department
FROH:
Springfield Fire Department
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SUBJECT: Structural Damage to Building
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Address or location of building
Name of owner
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tOwel/ling, Store, Warehouse, etc.)
Type of building
Estimated value of building S
30) oce.
Estimated loss to building S
..10.CJ('C'
Date of fire
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Loca ti on of damage in bu il di ng -1J." {/ <: . ti-",r.( " (' Ei,'I,,, \ , 0 4-
...illu.ff r("N"N.~ rl"l7t11 r jf{.t.Erf 1] II ri..r:p.
(Roof, Wall, Exterior, Interior, ,etc;)
StrlJctural weakness as a result of the fire ~ 1.......k~I.Dr p,,,.-I-,'.J..;,,J ::>
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Additional pertinent information
Electrical Hazard l'ihAlSiul r(~",,,,,.. -Ie .4tf rh.-f !'"it I1m-f-J nll.J h',,-cr
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(Wiring, Outlets, etc.)
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BUILDING DIVISION 346 MAIN STREET 726-3753
WE HAVE INSPECTED THE ElECTRICAl WIRING AND EQUIPMENT INSTAllED BY YOU AT THE PREMISES NAMED HEREIN AND SUBMIT
THIS REPORT FOR YOUR RECORDS. . \ OWNER 01l l\^ . r, c- Q W
TO TENANT . V \0 " ~^'" ~ ~ .^
LOCATION OF ,t C'\ . I I"
JOB ,,-. "I . I...\~L":\ 1M"........ -I'.~
o WIRING APPRO'IED FOR COVER 0 A PERMIT IS REQUIRED . IJ
o APPROVED FOR SERVICE 0 HEAT CABLE APPROVED FOR COVER
o WIRING INCOMPLETE 0 UNDERGROUND APPROVED FOR COVER
o WIRING COVERED wmlOUT INSPECTION 0 CONDUIT SYSTEM APPROVED FOR COVER
o DUE TO THESE PREMISES BEING LOCKED AN INSPECTION COULD NOT BE MADE
o DUE TO NO ONE HOME AN INSPECrON COULD NOT BE .MAD!:
o WIRING APPROVED FOR COVERING EXCEPT THE FOllOWING
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, A. K. Brl;;. Company. Inc.. fIlgClM. Oregon
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BUILDING LETTER REQUEST FORM
Date:
3/ID /e~
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Name: .-1f~ t!/J3fb4
Salutation:
/?/77# ~ fl!;8~OIe; r
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Fi rst
Last Name:
S'LtllJ~.
Owner's Address: .*,^
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~A./#'J"P/e--(.(), tJ)( ~ 7,77
Review Date: 4.-11l) lee
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Number of Bldgs.
Header Paragraph # ~
Is This Letter Certified? ~/ No
Inspection Address:
S"'~ ~
Proposed Use:
Type of Bldg.
Is This Letter Formal? Yes /~
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STRUCTURAL PARAGRAPH #' S __ r ELECTR ICAL PARAGRAPH #' S
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Ahy Changls V-- es No. J Any Changes Yes No
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MECHANICAL .I'ARA.GRAPH' II'S
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PLUMBING PARAGRAPH~II'S
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Any Changes . /' Yes No Any Changes LYes _ No
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SPECIALTY HEADING CLOSING PARAGRAPH #'S
Title: - /1 J 2-
Paragraph #'s .-
Any Changes Yes No Any Changes Yes ~o
==========================================================================
SIGNATURE #'S ~J"~
CARBON COpy #' S )1IfYE. .>>/.;A::;,I;- ~
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