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CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Work to be Done in Accordance with <br />City Ordinance <br />Ev�:rett, Washington ................'.............�.... .., 19�•1>' <br />�,-. , <br />/ (r �n /:..�a�...�._ /.� r�:�i <br />Location ........................... ..........:y........ � . <br />�• . <br />...................... <br />�_f « t.;.�.,. 1;' ' rt�.� ..i <br />Owner................. ........................................................... <br />Applicant �'�` - � � <br />......................._...................................__...__.. <br />>• <br />Rough piping inspettion _ _ ..._. . <br />Pipe in ercess of 60' . Gas Stoves <br />Gas refrigera!ors Gas water heaters X <br />Gas space heaters to 70,000 B.T.U. input _ r x. <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 f3.T.U. input <br />Conversion units to 400,000 D.T.U. input <br />Conversion Units over 400,000 B.T.U. input <br />Small appliances. . . .. <br />_.. .. ---�---� <br />/ r c: <br />Call Back Inspection Fee Paid $ __� ... <br />,s <br />..--� - �-�� L �-�--j--`�--- - �PPlicant <br />�. . � 9� - '. y ` <br />B , �.{.4� J�' �'^ - <br />y_ __— __ - - <br />Plans approved and Permit granted as requested hercin. <br />�:�'t <br />��-�`� �'�'�' `'�- Inspedor <br />E3y <br />PERMIT <br />