2000, 06-15 Notice of Hazardous Conditions or_
4ui i_ STA 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: F itRt4 f tiA41,;Lfix- Location:
CONDITIONS ❑ Apparent cracked or restricted heat exchanger ❑ Inoperative safety system
FOUND: ❑ Spillage of exhaust at the draft hood after a ❑ Insufficient combustion/ventilation air t
reasonable warm-up time ❑ Gas leak at gas equipment
❑ Damaged appliance connector ❑ Other f' , ' . r•"[. /- e-
❑ Damaged or disconnected vent X..-
0
es.❑ Defective limit control
❑ A gas leak in your house piping in the amount of CFH
with all known appliances off
1 have read, understood and acknowledge receipt of this notice. ❑ Owner ❑ Tenant ❑ Agent
❑ Refused to Sign
Customer Signature
_1S— i
Service Representative f it �. -.6 :
e 7%L f 1(1 Date Tme x``4` am/pm
Equipment Disconnected? ❑ Yes I No Equipment Tag Left? ❑ Yes ❑ No Authority Notification Required? ❑ Yes ❑ No
Equipment Left ❑ On )Off Meter Leftt'Off ❑ On
White Copy—Customer Yellow Copy—Attach to Service Order Pink Copy—Authority Having Jurisdiction Hard Copy—Appliance
1 1't
.Il'._%.1.1,.l
T_� 11se'... C O U NT T Y
S P O K A NT E � _
BUILDING AND CODE ENFORCEMENT A DIVISION OF THE PUBLIC WORKS DEPARTMENT
James L.Manson,C.B.O.,Director Gary Oberg,Director
July 19,2000
Mary Ellen Peterson
721 S University #3
Spokane,WA 99206
RE: Notice of Unsatisfactory Condition—Floor Furnace
Dear Mary Ellen Peterson:
Our office has been informed that an unsatisfactory condition may exist with regard to the floor 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 8:00 a.m. and 4:00 p.m. Our phone
number is: (509) 477-3675.
S A erely,
4111 \
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