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CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Work tu be Done in Accordance'wfth <br />City Ordinance <br />Everett, Washington,...........1.�-� .Z � <br />.................t...., 19... �.. <br />� r ,�' ^ <br />l.ocation.......!. �. � , <br />........................ l�`IL <br />f/� [,� * .................................. <br />Owner.....1!�!.... J` ( r1-�t4t�!'iii: , <br />............. .................... <br />�..... <br />� . , /1', ,- � . <br />Applicant :............:�..�...WYi1�CA.tt.CZ , - • <br />....�.� . .......................................... <br />Rough piping inspection _ __ �.__ <br />P�pe in �ccess of 60' _ _ _ _ __ Gas Stoves _ __ � _. _ <br />Cas refrigerators ___.` �Gas water heaters _� <br />Gas space heaters �0 70,000 B.T.U. input ____�___ _ <br />Gas space heaters over 70,000 B.T.U. input ________ <br />Gaa fuin3ces •to 400,000 B.T.U. input ___ <br />Gas furnaces over 400�OOP B�T.U, input ____,__ __ <br />Conversion units to 400,000 B.T.U. input _ <br />Conversi�n w�its over 400,000 B.T.U. input ____ <br />Small appliances.__.______.� <br />Call Backllns ection _ f �a <br />N . Fee Paid $_ S � <br />,i�j ,O ,�.,_... <br />— <br />`.-.."---_ . iv _`___ li � <br />- .`-.!______!_ _ <br />. . ------ . . APP� ican t <br />Gt�.4,-8�''' / Z <br />BY.,. . _ 7 - - -- <br />F'Inns approved and Permit granted as requested herein. <br />. '.��A <br />'v�w_ , - : -_ - Inspector <br />Qy <br />PERMIT `� :' -� �;; � <br />