1999, 03-08 Notice of Unsatisfactory Condition L
S P O K �i ��; C O U N T Y
IPiIIe^s
BUILDING AND PLANNING • A DIVISION OF THE PUBLIC WORKS DEPARTMENT
JAMES L.MANSON,C.B.O.,DIRECTOR DENNIS M.SCOTT,P.E.,DIRECTOR
March 8, 1999
Marge Dockins
4720 S. Woodruff
Spokane, WA 99206
RE: Notice of Unsatisfactory Condition -4720 S. Woodruff
Dear Marge Dockins:
Our office has been informed that an unsatisfactory condition may exist with regard to the (furnace etc.)
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.
Sincerely,
Ann Douglas
Office Assistant 4
1026 WEST BROADWAY AVENUE • SPOKANE,WASHINGTON 99260
PHONE:(509)456-3675 • FAX (509)456-4703
TDD:(509)324-3166
AL_ S-0308(1-99)
Auir/IS t NOTICE OF UNSATISFACTORY CONDITIONS
Utilities .-.� %c
f'l Phone Number f.
Customer Name C ' '6'
�j,, City
Addressrty age,personal injury,or loss
TYPE IOFC ❑ HAZARD The conditions noted below constitute an off pending furtherli inspiate ection andard repairs, nd shall not be tmay result in urned ed back on until such repairs have
NOTIFICATION: of life.The equipmentyhas been turnedp
been completed by a qualified HVAC dealer,contractor,or service agency,and the equipment has been brought up to current safety
standards.Do not attem.tto use this eIui,ment until it has been resaired.
LI WARNING The con
finoted constitute
oa Although
condition
llimmediate
threatlifeor property,failure to correct the condition may lead to hazardous condition. contact a qualified HVAC dealer,
to
contracto,
or service agency to perform further inspections or to bring the equipment up to current safety standards.
Location:
Equipment Type:
U Inoperative safety system
CONDITIONS ❑ Apparent cracked or restricted heat exchanger ❑ Insufficient safety
combustion/ventilation air
FOUND: ❑ Spillageesonof exhaust at the draft hood after a ❑ Gas leak at gas equipment
reasonable warm-up time ❑ Other
U Damaged appliance connector
❑ Damaged or disconnected vent
U Defective limit control CFH
❑ A gas leak in your house piping in the amount of
with all known appliances off
I have read, understood and acknowledge receipt of this notice. ❑ Owner ❑ Tenant ❑ Agent ❑ Refused to Sign
Customer Signature Date Time am/pm
Service Representative
Equipment Disconnected? ❑ Yes ❑ No Equipment Tag Left? ❑ Yes ❑ No Authority Notification Required? ❑ Yes ❑ No
Left ❑ Off ❑ On
Le
Equipment Left U On ❑ Off Meter q Bance
White Copy—Customer Yellow Copy—Attach to Service Order Pink Copy—Authority Having Jurisdiction Hard Copy pp
RECEIVED
SPOKANE COUNTY •
FEB 2 3 1999
DIVISION OF BUILDING AND PLANNING
BY:
I