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i <br /> Gas Installation Permit � , ;,, , ,, , , . ; <br /> City of Everett DEPARTMENT OF PUBLIC WORKS <br /> Date � ` <br /> �.� . �' . ,. ,: � / <br /> Appliencn L No. Addre55 /= � O y („���'�5 7/t�U! <br /> Convcrvan Uni�s QWI1Cf � . �` ��--� <br /> IO 400,000 BTUs —1 <br /> Convcrsion Unrts l i �• <br /> . InStallcr__.__ _,;.y,.�� <br /> over 400,000 BTUs � /� <br /> Cookstow�s City ol Everct�, by_____�__�_____ <br /> Renge To�n – On'ns <br /> Furnsce:toaoo.000B*us — IMPORTANT NOTICE — <br /> Fumecis aver A00,000 BTIJs All work must conbrm to �I1C {1I019510f15 0� the orzlinances o( the City of Everett, <br /> S���o Hcaicrs to 70,000 B7Us Washinyion. It IS lI1C fCS�]Of151I)Ill�y of the Permit Holder w u:e ihat Ciry Inspection <br /> Snace Hca��rs over 70,000 B7Us Division is notifir.d and the installation inspectecl befom wvering. <br /> Frteplacc Log <br /> - Remarks and Cnrrer.tions�. ,_ __ -- <br /> Wntcr Hwturs <br /> PiPmg ..... _.' . _ ____._.. ___ — <br /> Pqir in raress ol 60' <br /> ---- ImPcr.tion --Datc _ InsPectoi .---- <br /> C�olhrs Orycrs <br /> An Cnndiboning Unrtf Cil�� Bi1Ck —�llC___ �f15�)CCIOf — <br /> Bniler <br /> —. Final — Datc InsPectoi __ __ . —__-_ <br /> -- ) -- —�---- --- <br /> ---��-- --- <br /> . �� <br /> Thiti Prnni� nui�l b�� putiied on Jnb befo�a S���rting Inalalluii��n. <br /> Permit Fae . : . . CJ � - ' <br /> Pcrmn <br /> ��-. <br />