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CITY OF EVERETT <br /> Appficatwn and Gas Installation Permit <br /> All Work to be Done in Accordance'with <br /> City Ord�nance <br /> Everett, Washington........�.:�. ?:�-1-�- �� <br /> � ............. ........... 19.(...j:. <br /> 'i � � ; <br /> Location.. ...�7'...�:.�..�....�� �t ' <br /> u.F - <br /> � . ................-C. ..........._..._.._._ <br /> Ownec__.....'jj.�`..dr...�'�A'H- �.... <br /> .........�.................................. <br /> Applicant..._.._....�:(_.'1!��.�...... ' <br /> ................................. <br /> Rough piping inspection __/�_ . <br /> Pipe in ex�ess ot 60' ._ . _ Gas Stoves _ _ <br /> Gas refrigaretors Gas water heaters__t. .._._ <br /> Gas space heaters to 70,000 B.T.U. input - _— <br /> Gas space heaters over 70,000 B.T.U. input __.___ <br /> Gas furnaces to 400,000 B.T.U. input ___ _.�_ _ <br /> Gas fumaces over 400,000 Q.T.U. input _ _ <br /> Conversion units to 400,000 B.T.U. input _ _ _ <br /> Conversion units over 400,000 B.T.U. input <br /> Small aPPliances _ _ _ . -_ __._. <br /> _ ._._...,.- - <br /> ___ �,Y,.__ <br /> er <br /> Cali Back Inspecfion . . Fee Paid $ ._:.. _;`" _ <br /> . .. . - . - . .. . . P,pplicant <br /> [ i <br /> By.. ....:�•��!_uG�./�-Tr . ;'i (. � / <br /> Plans approved and Permif granled as reques!ed �herein. <br /> i <br /> ���-��(-'%`-� - . Inspectoi <br /> ��, i /I - <br /> PERMIT � :'� ���-�� � �; <br />