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GTY Or EVERETT <br /> Applicafion and Gas Installation Permit <br /> /�II Work to be Done in Accordance wifh <br /> City Ordinance <br /> . �r • , „� <br /> Evurett, Washington....... ... �S.e...../�......., 19G. f.. <br /> Lotation...cl4.�.�Q.11..:P�...,y� I ' �G:}-rMri,................ <br /> Owner......W.T.,......�p Y��A.�.:k..+- <br /> . . <br /> . . ..... . ... ............................. <br /> Applicant.,..'..:..:�(..�..�d....fw.. <br /> ......................................... <br /> Rough piping inspection . !�. <br /> Pipe in excess of 60' _- _ _ Gas Stoves � <br /> Gas refrigerators Gas water heaters .x <br /> Gas space heaters to 70,000 B.T.U. inpuf �___ <br /> �as spacc heaters over 7C,000 B.T.U. input __ <br /> Gas fumaces ro 40Q�)00 B.7.U. input __ _ <br /> Gas fumaces ovcr ;OO,OU� B,T.U, input . _ __ __ <br /> Ccnversion ur�its to 400,000 B.T.U, input ___ __ <br /> Conversan units over 400,000 B.T.U. input _ _ _ _ <br /> Small applian:. , - -- -_.______ --- '- <br /> I _ .... ..--� -- -. . — - - ---�-�-- <br /> Call OackJnrp�ctio�i . .. _ _ Fee Paid 5..� �..... <br /> , ,.....__._.._._.__.._�._��__2_'_/ _-- l�pplicant <br /> Uy.. ..L�Y'!�.�I'�• �l? � <br /> Plali�s approved and Permit granted as requested herein <br /> ;�'C; � <br /> . . � -/��-�—��- � - . . Inspedor <br /> Cy � <br /> PERMIT .A':' ! 1y�3 <br />