HomeMy WebLinkAboutSpecial Inspection Fire Damage Report 1986-11-14
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
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DATE:
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TO:
Bui 1 di ng Depa rtment
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FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Name of
or location of building /.J:)L( r JJ-
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o\'mer
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Address
Type of
Estimated value of building .$
Estimated loss to building $
Date of fire
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damaae in building .cy;~ ~),-,,1~.->
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(Roof, Wall, Exterior, Interior, etc.)
weakness as a result of thefire'~hA--' a_/~.F
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(Burnehafters, Seams, 'Joists, etc.) v
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Locat~on of
Structural
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Additional oerti,nent information
Electrical Hazard
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(Wiring, Outlets, etc.)
Signed (] ~
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