2001, 05-23 Notice of Unsatisfactory ConditionBUILDING AND CODE ENFORCEMENT
James L. Manson, C.B.O., Director
May 23, 2001
Cindy Jepson
1005 N Bowman Rd
Spokane, WA 99212
RE: Notice of Unsatisfactory Condition - Gas Piping
A DIVISION OF THE PUBLIC WORKS DEPARTMENT
Gary Oberg, Director
Dear Cindy Jepsen:
Our office has been informed that an unsatisfactory condition may exist with regard to the underground gas piping
located at the referenced address.
This notice is to inform you that should you install new equipment, you must obtain a permit.
Should you have any questions, please contact this office between the hours of 8:00 a.m. and 4:00 p.m. Our phone
number is: (509) 477-3675.
der
Sijcerely,
60.."(k).:ku-t-44
Diane Truax
Office Assistant IV
1026 W. BROADWAY • SPOKANE, WASHINGTON 99260-0050
PHONE: (509) 477-3675 • FAX: (509) 477-4703 • TDD: (509) 477-7133
Utilities
NOTICE OF UNSATISFACTORY CONDITIONS
Customer Name
Address
TYPE OF
NOTIFICATION:
Equipment Type:
CONDITIONS
FOUND:
S-0308 (1-99)
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 turned off pending further inspection and repairs, 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.
❑ WARNING The conditions noted below constitute a potential hazard. Although the condition does not present an immediate
threat to life or property, failure to correct the condition may lead to a hazardous condition. Please contact a qualified HVAC dealer,
contractor, or service agency to perform further inspections or to bring the equipment up to current safety standards.
Location.
❑ Apparent cracked or restricted heat exchanger
❑ Spillage of exhaust at the draft hood after a
reasonable warm-up time
❑ Damaged appliance connector
❑ Damaged or disconnected vent
❑ Defective limit control
❑ A gas leak in your house piping in the amount of
with all known appliances off
CFH
❑ Inoperative safety system
❑ Insufficient combustion/ventilation air
❑ Gas leak at gas equipment
❑ Other ?,
I have read, understood and acknowledge receipt of this notice. ❑ Owner ❑ Tenant ❑ Agent
Customer Signature
Service Representative Date
Equipment Disconnected? ❑ Yes ❑ No Equipment Tag Left? ❑ Yes ❑ No
Equipment Left ❑ On ❑ Off Meter Left ❑ Off ❑ On
White Copy—Customer Yellow Copy — Attach to Service Order
❑ Refused to Sign
Time am/pm
Authority Notification Required? ❑ Yes ❑ No
Pink Copy—Authority Having Jurisdiction Hard Copy—Appliance