HomeMy WebLinkAboutSpecial Inspection Building 1985-10-25
CITY OF SPRINGFIELD
Department of Public Wor
Building Safety Division
225 North 5th St~eet
Springfield, Or~gon 97477'
7 2 6 - 3 7 5 3 ( Bus .) 7 2 6 - 3 7 6 9 (I n s p . )
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JOB ADDRESS: ~ .~ C\ '1 ,tA s+-Qtr
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OWNER: ' "\ A Y\. \0...' \ P rf\ ~ P
OWNERS ADDRESS: ~O ch~v-\e.s' e==. ((\\~ Q-c=a.. (+GJ . ~Y\c....
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APPLICANT: C ~,Q '\ \~? t~ t t 1,',,- ~ ea.. \ ~j r I.f'.e-
APPLICANTS ADDRESS: 0C-f (0 t'J (QXZ-+~ (A- ~ +-re{'-\-- : ~ f \ Of2-e
FOR ACCES S TO PROPERTY - - PLEASE INCLUDE TELEPHONE NUMBER: 7 C-{ & ~ ~ ~_ -- 7 n
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.' - HOUSYNG INSPECTION Y
APPLiCATION (/',;Y
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SPRINGFIELD
DATE:
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A $30.00 INSPECTION FEE IS REQUIRED AT THE TUm OF
APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTED. ., "
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SIGNATURE OF PROPERTY OWNER
FOR OFFICE USE ONLY
------------------------~-~---------------------------------------------------
DATE OF INSPECTION:
RECEIPT NUMBER: e? 5--"5' .::L7
DATE PAID: (0 - d-.5-fS-
DATE OF REPORT:
DATE OF CERTIFICATE OF COMPLIANCE:
COMHENTS:
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CITY OF SPRINGFIELD
Department of Public War
Building Safety Division
225 North 5th Street
Springfield, Oregon 97477
726-3753 (Bus.) 726-3769 (Insp.)
HOUSING INSPECTION Y
APPLICATION ~j
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SPRINGFIELD
DATE:
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JOB ADDRESS: 3 <:0 C\ '1 'A S+-flU
OWNER: f"' G\ '^ V'\.. \' (J r(\ C\.. 'P
OWNERS ADDRESS: ~O ch.G\"\~.s ~ ((\'~Qt=Cl (-+Vl~v'\ C_ .
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APPLICANTS ADDRESS: 0C-f (0 N (Qxe-+~ fA- <S. +'{"'~~ I ~ f \ Or---e I
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FOR ACCESS TO PROPERTY--PLEASE INCLUDE' TELEPHONE NUMBER: 7C-{ G? ~ ~? -- (n
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APPLICANT:
A $30.00 INSPECTION FEE IS REQUIRED AT THE. TUm OF
APPLICATION '
THIS APPLICATION FORM MUST BE SIGNED BY THE OWNER OF THE PROPERTY TO BE
INSPECTEP..- . _I .
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DA..:}..~~'~'F-IN.S.EEc~-T!ON: RECEIPT NUMBER: I I~:-S &5 c:- ;2.7::
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DATE OF REPORT: DATE PAID: (0: - if5 -fS- ,,':
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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