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CITY OF EVERETT <br />Application and Gas Insfallation Permit <br />All Work to be Done in Accordance with <br />City Ordinanc=• <br />Evorett, Washington..........�...` � ( `'' <br />....................... 19......_. <br />;' . <br />Lccation .....:. . i , ::. o� ., �_� - r., ^ <br />1 . <br />........................ ,... �. <br />... .................. ............. <br />Owner ........:.:.:�ric_ r.,.,�ta.i' <br />............................................................... <br />Applicant "�, " � � <br />.........................._...................._......___._........ <br />Rou h '�' <br />g piping inspection _ .. <br />Pipe in excess of 60' _ Gas Stoves <br />Gas refrigerators - Gas wate� heaters <br />Gas space heaters to 70,000 B.T.U. input __ ___'� <br />_ ._ <br />Gas space heaters ovcr 70,000 B.T.U. input <br />Gas furnaces to 400,U00 B.T.U. input <br />Gas fumaces over �400,000 D.T.I(. input _ <br />Convcrsion units to 400,000 E3.T.U. inpul <br />'�onversion Units ovcr 400,000 B.T.I), ]nput <br />Small appliances- _ <br />— — ----- <br />:�.-- <br />Call Back Inspection _ Fee Paid $_ �� � <br />' e , 1 .__._, <br />___ . �_ .'..— -- . Applicant <br />r <br />r ! J ., i <br />BY....'."__ _'_ ._ _ `r_....i�. j /. �� .- � <br />Plans approved anrl Pcr.nit granted as requested hcrein. <br />�:�� .�+� l <br />�(.J ��(._, i _ : :.t.•t� <br />�- Inspector <br />oy <br />PERA+{IT <br />