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1 <br /> GTY OF EVERETT 'I <br /> Application and Gas Installation Permit � <br /> All Work to be Done in Actordance wi�li <br /> City Ordinance <br /> rq / '� <br /> Ev�erett, Washin�ton....... ...?.....CK...�../. ... 19�i,?.. <br /> Location........ �.�f..�..7..._�-.9W:!v......�............. <br /> / ,.... , <br /> Chvner..........��.''.Z.R�:�r!-2!��..�tiT_. .F...�10.w�7�.�.... <br /> ApplicanL.:..:....;.,r��.'�......:.... ....................._....-_ <br /> Rough piping inspection _J�_ .. _ ,/ <br /> Pipe in excess of 60' . _ _ —. Gas Stoves �\ <br /> Gas refrigeratcrs Gas water hsaters_�._._ <br /> Gas space heaters to 70,000 B.T.U. input - __� <br /> Gas space her�ter� over 70,000 B.T.U. input . _ _ <br /> Gas fumaces to 400,000 B.T.U. ihput . _ _ _ _ <br /> Gas fumaces over 4pQ�p00 ,Brr.U� input . _ . _ <br /> Conversion �nits to 400,000 B.T.U. input _ _ <br /> Conversion units over 400,000 B.T.U. input _ ._ _ - <br /> Small app��ances. . ._..-------___..___.�...�....-'--. ... <br /> � Bac'cJn _ _ . .. _ - - — �- • <br /> / -F. • - - <br /> Cal �� <br /> spection _ Fee Paid $._. GL �.,._. <br /> f. � <br /> . ..._. - .__._ .. - --. __ . . .._..___. . _. . _ _ APP.licant <br /> ��� • <br /> BY; � ; --- <br /> Plarr, approved and'Permit granted as requcsted lherein. <br /> . f� ��{�I:�rt�, C,"G!.� Inspecfor <br /> gti I` / �I V <br /> PERMIT '4,"�' ;3 �? �ii� <br />