HomeMy WebLinkAbout65275 (2) r CITY OF GLENDALE
FIRE DAMAGE INSPECTION REQUEST
GLEN E
Council District: Inspection Area: �.-
Address of Fire: O L_1✓1
Requested by: V\(-A r� C,C� L 1 I Telephone No.(s) 1 I ODD Vi
Request taken by: 7 Date of request: .�' ^ t0 _ 13S C�1
Other comments:
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. 3rmits Required: ❑ Combination tl.fuilding Electrical ❑ Plumbing la chanical
Permit Fee: $ Investigation Fee: $
Ce .iiptioil of plans or other information required:
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Special Conditions:
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COPY TO REMAIN POSTED ON JOB SITE
Address of Fire: 6/0 A.) , 9 4 -1- &.
Areas Damaged and Description of Damage:
Garage/Carport
Living Room:
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Bedroom( 1:
Kitchen:
' Bathroom(s):
Laundry Room/Utility:
Patio:
ooflAttic:
Utilities Disconnected: Electric: Yes No L/ Gas:Yes No
Inspector: ( il Date of Report: S,— k 69 6