2003, 11-21 Notice of Hazadous Conditions�u VISTA'
Utilities
NOTICE OF HAZARDOUS CONDITIONS
Customer Name
Address e,'
TYPE OF
NOTIFICATION:
S-0308 (08-01)
Phone Number
City
❑ HAZARD The conditions noted below constitute an immediate hazard and may result in property damage, personal injury, or loss
of life. The equipment has been disconnected or left inoperable, and shall not be turned back on until such repairs have been completed
by a qualified HVAC dealer, contractor, or service agency, and the equipment has been brought up to current safety standards. Do not
attempt to use this equipment until it has been repaired.
Equipment Type:
CONDITIONS
FOUND:
Location•
Mfr
❑ Apparent cracked or restricted heat exchanger ❑ A gas leak in your house piping in the amount of
❑ Damaged appliance connector
❑ Damaged or disconnected vent
❑ Gas leak at gas equipment
with all known appliances off
❑ Insufficient combustion/ventilation air
❑ Other
CFH
Meter Left ❑ Off ❑ On Meter Number Meter Read
I have read, understood and acknowledge receipt of this notice. ❑ Owner ❑ Tenant ❑ Agent
Customer Signature ❑ Refused to Sign
Service Representative Date Time
WhiteCopy— Customer yellow Copy — Attach to Service Order Pink Copy— Authority Having Jurisdiction Hard Copy — Appliance
"'I am/pm )
mmmtpli
•
'V PLUS - Permits Land Use System
1 Ede Edi t View Insert Fcerriat Record s Dols Window tido
16116
Parcels
Site Namel Li inspector District J LI
1 Stte Info 1 Protects 1 Plat 1 Notes 1 Bldg info 1 CompltdKe 1 Images 1 Other
Parcel Nbr Nbr Nit Marne
45142.2005 014109 E JBOONE
Loc City
SPO LISPOKANE
Owner s)
Type 21
AVE •
St Cntry Zip Code
WALI • 99216 0
SCORE
Legal Deso
Owner
WEST, JEFF Phone: (509) 879-3482
14009 E BOONE AVE FAX:
SPOKANE, WA 99216 008:
E -Mail
Occupant
Phone:
FAX:
DOB:
E -Mail
Record: 11 1 I 1 1 1It+1 of 1
New Site
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Display Note
:A421.41i10
Monday, Dec 15, 2003 03:08 PM
Inbox ,„
0 Site JFINAL .„
2 BLDG
1Docurr