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FORM FURNISHED BY INLAND NORTHWEST HVAC ASSOCIATION.
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CUSTOMER SIGNATURE
OWNER ❑
AGENT ❑
PRINT NAME
DDRESS
TYPE NOTIFICATION
❑ HAZARD
CONDITION TO BE CORRECTED AS SHOWN BELOW CREATES AN IMMEDIATE HAZARD. THIS EQUIPMENT
MUST NOT BE PUT BACK IN SERVICE UNTIL REPAIRS AND A THOROUGH INSPECTION HAVE BEEN
MADE. ISSUER'S PHONE NO
❑ WARNING
CONDITION TO BE CORRECTED AS SHOWN BELOW IS NOT IN ACCORDANCE WITH SAFETY STANDARDS
AND COULD CREATE A HAZARD. CORRECTIONS AND A THOROUGH INSPECTION MUST BE MADE
WITHIN TWO WEEKS. ISSUER'S PHONE NO
CONDITION TO BE CORRECTED:
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REPAIRED BY COMPANY
INITIAL
TIME
DATE
CONDITION CORRECTED
YES ❑ NO ❑
INTALLED HAZARD TAG YES ❑ NO ❑
COPIES SENT TO: (1) CUSTOMER (2) ISSUER (3) AUTHORITY HAVING JURISDICTION (4) EQUIPMENT TAG
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S P O K A N E -0114"
' ° 14, ;>,. C O U N T Y
DEPARTMENT OF BUILDINGS • A DIVISION OF THE PUBLIC WORKS DEPARTMENT
JAMES L. MANSON,C.B.O.,DIRECTOR DENNIS M.SCOTT,P.E.,DIRECTOR
October 11, 1994
Robert Merrill
E 12922 Semro Road
Spokane, Washington 99216
RE: Notice of Unsatisfactory Condition - American Standard Forced Air Furnace
Dear Mr. Merrill:
Our office has been informed that an unsatisfactory condition may exist with regard to the
furnace located at the above-referenced address.
This notice is to inform you that should new equipment be required, you will need to
obtain a permit. If new equipment is not required, please disregard this notice.
Should you have any questions, please contact this office between the hours of 8:00 a.m. and
4:00 p.m., weekdays.
Sincerely,
-47(a-66,„ 71/ 40;
Marcia I. McGarrigle
Office Assistant
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1026 WEST BROADWAY AVENUE • SPOKANE,WASHINGTON 99260 • (509)456-3675
FAX(509)456-4715 • TDD (509)324-3166