HomeMy WebLinkAboutBuilding Miscellaneous 1990-2-1
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CITY OF SPRINGFIELD
Department of Planning and D.pment
Building Safety Divi
225 N~rth 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
HOUSING INSPECTtIII.
APPLICATION
Cl r~YI .5 <6
SPRINGFIELD
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DATE: "3G,IlLA(l(\/ '3119g0
JOB A~DRESS: ~S1 (~,uetr.l~\1.l t?d.J s.:,-\cl, n~
OWNER: Sv('('.,""'1 K ( ~p I J
OWNERS AD~ESS: ~QS~ktl V,e.\A/ I nile. &>tct CAe
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APPLICANT: li(;(o-8~ l), NOJt::~3 ~"'GE-('\lS., Mc.l~elJ ~('(',-C(""R
APPLICANTS ADDRESS: ~LjOS K-->.W,,/ U'elA.) \ nct.t'. S."J!d, 'he
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE TELEPHONE NUMBER: ~~(,-~~ lF1~
J'r.ll ~ h~<:. l?--i~- -/-'" ;\:-1~~('tlo\ ~'-7 l'l1r-rlf'J i1-1 e.nG..We.. u<:' f.-() ci.ve.
i(b"tit~, 'to \k\1.~~ 1 \J '
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIHE OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED.
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S~ PRm,ERTY OWNER /'
FOR OFFICE USE ONLY
DATE OF INSPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COHMENTS:
RECEIPT NUHBER: \ '0CJ ~ 8"
DATE PAID: /;)...)...q()
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