1999, 07-29 Notice of Unsatisfactory ConditionBUILDING AND PLANNING
James L. Manson, C.B.O., Director
Richard Keller
E. 6822 9th
Spokane, WA 99212
July 29, 1999
RE: Notice of Unsatisfactory Condition - Furnace
Dear Richard Keller:
A DIVISION OP THE PUBLIC WORKS DEPARTMENT
Gary Oberg, Director
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 8:00 a.m. and 4:00 p.m. Our
phone number is: (509) 477-3675.
der
Sime rely,
Diane Riordan
Office Assistant 4
1026 W. BROADWAY • SPOKANE, WASHINGTON 99260-0050
PHONE: (509) 477-3675 • FAX: (509) 497-4703 • TDD: (509) 324-3166
• daI''ISTA
Utilities
•
Customer Name
Address
NOTICE OF UNSATISFACTORY CONDITIONS
TYPE OF
NOTIFICATION:
Equipment Type:
CONDITIONS
FOUND:
Phone Number
S-0308 (1-99)
City
❑ 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.
❑ 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.
O Apparent cracked or restricted heat exchanger
O Spillage of exhaust at the draft hood after a
reasonable warm-up time
O Damaged appliance connector
O Damaged or disconnected vent
O Defective limit control
O 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.
Customer Signature r
Service Representative 11)-( [ ► �f,1 C.{./
Location: ...d.f ux P.14 _/t
❑ Owner
CFH
O Inoperative safety system
O Insufficient combustion/ventilation air
O Gas lealc�t gas equipment
O Other
% X/27
G2 CL .
❑ Tenant 0 Agent
Equipment Disconnected? 0 Yes 0 No Equipment Tag Left?
Equipment Left 0 On , Off Meter Left 0 Off 0 On
White Copy Customer Yellow Copy -Attach to Service order
Yes 0 N
Date
0 Refused to Sign
Time // • 7= 'am/pm
Authority Notification Required? ❑ Yes
Pink Copy - Authority Having Jurisdiction Hard Copy - Appliance
0 No