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2000, 04-26 Notice of Unsatisfactory Conditions - ' i Am_ NOTICE OF UNSATISFACTORY CONDITIONS S-0308(1-99) Utilities Customer Name Phone Number • Address City • TYPE OF ❑ HAZARD The conditions noted below constitute an immediate hazard and may result in property damage,personal injury,or loss NOTIFICATION: 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. Equipment Type: Location: PONDITIONS ❑ Apparent cracked or restricted heat exchanger ❑ Inoperative safety system OUND: ❑ Spillage of exhaust at the draft hood after a ❑ Insufficient combustion/ventilation air reasonable warm-up time ❑ Gas leak at gas equipment ;rr ❑ Damaged appliance connector ❑ Other ❑ Damaged or disconnected vent ❑ Defective limit control ❑ A gas leak in your house piping in the amount of CFH with all known appliances off I have read, understood and acknowledge receipt of this notice. ❑ Owner ❑ Tenant ❑ Agent Customer Signature ❑ Refused to Sign Service Representative Date - Time am/pm Equipment Disconnected? ❑ Yes ❑ No Equipment Tag Left? ❑ Yes ❑ No Authority Notification Required? ❑ Yes ❑ No Equipment Left ❑ On ❑ Off Meter Left ❑ Off ❑ On White Copy-Customer Yellow Copy-Attach to Service Order Pink Copy-Authority Having Jurisdiction Hard Copy-Appliance '4, i Ipii, ' , -1 { EI S p O K A N E • i' lr,rjrrr�� .;^il,i'' C O U N T BUILDING AND CODE ENFORCEMENT A DIVISION OF THE PUBLIC WORKS DEPARTMENT James L.Manson,C.B.O.,Director Gary Oberg,Director May 11,2000 Eric Riese 813 University 'oa. Spokane,WA 99206 RE: Notice of Unsatisfactory Condition- Gas Piping Dear Eric Riese: Our office has been informed that an unsatisfactory condition may exist with regard to the gas piping downstream of the meter 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. cerely, L. 44.) Diane Riordan Office Assistant IV der 1026 W. BROADWAY • SPOKANE, WASHINGTON 99260-0050 PHONE: (509)477-3675 • FAX: (509)477-4703 • TDD: (509)477-7133