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� <br />CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Worl; to be. Done in Accordance �wiili"-' ' <br />- - - Gity Ordinance .- -. _ _ <br />/, • <br />Everett, Washingtop�: -- �.^.i:^.e..:.��.........,..1.9_G. `. <br />Location.-.--....�."t.� �.��`.:�rY�r..^i-.-�- �..- --�---..... <br />..�.. . .. �� �. . _ <br />Owner...........:p�.%� C�Y,c.:�--�--�t;u�.,w7`"' <br />�� �;u•z .. --. ,>. ' <br />��c .. . .. _ _ _ _ _ <br />P,pplicant...._.....: :� i��?Li�'e=n-�/ , . <br />. . . . . . . .........--.....--�--.... ..... _... <br />Rough piping inspection x _ <br />Pipe'in excess af 60' �; •`- ��' Gas SToves _ <br />' / <br />Gas�,refrigerators - �Gas water..heaters._,�— <br />Gas_space heaters to 70,000 B.T.U. input � <br />"e;P . .. . . ...... . . . _ ._ . <br />Gas space heaters over 70,000 B.T.U. input <br />� aG , _ _. . . .. , . _ __ _ <br />Gas fumaces to 400,000 B.T.U, input <br />Gas furnaces over 400,000.,9.T„U, input <br />:�_ �.,..� , ,.�,:�. <br />Conversion units to 400,000 B.T.U. input _ <br />Conversion units over 400,J00 B.T.U. input <br />Sm�ll�appliances _ <br />�r1� �� �..�� , �.., o', <br />� ��,�/�� � ----'----��^ <br />' V�.,. ... 6p <br />Call Dack!Inspection - _. Fee Paid $ '" <br />Y,l� <br />—�—� . APPlicant <br />n <br />6y-_�_�r �.<_c_�.=��. „ <br />hlans`approved and Permit grar�ted as }equested 1Fie�ein: <br />_ ,'Y.'� i�v��"�' G ':c^�^;;7 Inspector <br />aY -�'� ��L -- <br />PERMIT I�?O 2 %'^r <br />