2000, 01-14 Notice of Unsatisfactory Condition •
4
i Iph1 !--i
S POK A N H C O U N T Y
BUILDING AND CODE ENFORCEMENT A DMSION OF THE PUBLIC WORKS DEPARTMENT
James L.Manson,C.B.O., Director Gary Oberg,Director
January 14, 2000
Cindy Burk
11205 E 29th
Spokane,WA 99206
RE: Notice of Unsatisfactory Condition - Boiler
Dear Cindy Burk:
Our office has been informed that an unsatisfactory condition may exist with regard to the boiler 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,
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
:,. Ansi__
�llii/ISTA® NOTICE OF UNSATISFACTORY CONDITIONS S-o3o9(1-99)
Utilities
. .1 i .1 1%,/ '
Customer Na je _`�• ' J jm Phone Number �-� ce ! '�
Address �f- ' ,...rte City ,)4 (11cl
TYPE OFf] 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: „,.!,,:,,,) 1 L.,•,-..,,
ype: ' Location: 15��1 S-r `1 ri r
iii-. CONDITIONS ❑ Apparent cracked or restricted heat exchanger ❑ Inoperative safety system
IL
FOUND: ❑ Spillage of exhaust at the draft hood after a ❑ Insufficient combustion/ventilation air
reasonable warm-up time ❑ Gas leak at gas equipment
i
❑ Damaged appliance connector i
Other ` ,
❑ Damaged or disconnected vent /.. F (' s
❑ Defective limit control
❑ A gas leak in your house piping in the amount of CFH Yf.i
with all known appliances off L
f
I have read, understood and acknowledge receipt of this notice. ❑ Owner ❑ Tenant ❑ Agent
Customer Signature ❑ Refused to Sign
Service Representative Date /` t � Time �� ' am/pm
%leEquipment Disconnected? ❑ Yes ❑ No Equipment Tag Left? ❑' s ❑ No Authority Notification Required? ❑ Yes ❑ No
Equipment Left ❑ On ❑ Off Meter Left ❑ Off U On
White Copy—Customer Yellow Copy—Attach to Service Order Pink Copy—Authority Having Jurisdiction Hard Copy—Appliance