2001, 12-20 Unsatisfactory ConditionAP -4 VESTA'
Utilities
NOTICE OF UNSATISFACTORY CONDITIONS
Customer Name
Address //•04°'
TYPE OF
NOTIFICATION:
Equipment Type:
CONDITIONS
FOUND:
Phone Number
S -030B (1-99)
City 1.1:, .r t-
. ✓�
❑ 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.
U WARNING The conditions noted below constitute a potential hazard. Although the condition does not present an immediate
threat to life or properly, failure to correct the condition may lead to a hazardous condition. Please contact a qualified HVAC dealer,
contractor, 0; service agency to perform further inspections or to bring the equipment up to current safety standards.
r' -4 p.„) `-
O Apparent cracked or restricted heat exchanger
❑ Spillage of exhaust at the draft hood after a
reasonable warm-up time
O Damaged appliance connector
❑ Damaged or disconnected vent
❑ Defective limit control
O A gas leak in your house piping in the amount of
with all known appliances off
Location -
CFH
❑ Inoperative safety system
O Insufficient combustion/ventilation air
❑ Gas leak at gas equipment J/
la Other ;•`: d e i!
1 have read, understood and acknowledge receipt of this notice. ❑ Owner 0 Tenant GI Agent 'r' f._ i s -
Customer Signature /- :1,:
Service Representative Date M ''"' (Time
Equipment Disconnected? ❑ Yes 0 No Equipment Tag Left? GI Yes 0 No Authority Notification Required?
,lU Refused to Sign
am/pm
LI Yes No
Equipment Left 0 On 0 Off Meter Left ❑ Off 0 On
Whtto Copy - Customer Yellow Copy - Attach to Service Order
Pink Copy - Authority Having Jurisdiction Hard Copy -Appliance
BUILDING AND CODE ENFORCEMENT
Janes L. Manson, C.B.O, Director
Occupant
9919 E Nora Ave
Spokane, WA 99206
C O U N T Y
A DIVISION OP THE PUBLIC WORKS DEPARTMENT
February 6, 2002
RE: Notice of Unsatisfactory Condition - Furnace
To Whom It May Concern:
Our office has been informed that an unsatisfactory condition may exist with regard to the furnace 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 8:30 a.m. and 5:00 p.m. Our phone
number is: (509) 477-3675.
det
Diane Truax
Office Assistant IV
1026 W. BROADWAY • SPOKANE, WASI IINGTON 99260-0220
PI IONE: (509) 477-7200 • FAX: (509) 477-2243 • TDD. (509) 477-7133