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CITY OF EVERETT <br /> Application and Gas Installation Permit <br /> All Work to be Done in Accordance with <br /> City .Ordinance <br /> �� � � ' ` � � � L� � <br /> - .,:-�r_,� ,� � <br /> Ev�rett, WashiD9ton--�>=�;��•---•------�..--••---� 19... _. <br /> lC/ % <br /> Location - - Q..S.�w!..r..::.._it:��::'�------- ----------- <br /> _ y. <br /> -` / <br /> , <br /> Owner -� •- -- ----.. ... ��=--�•'•z°�A...�....... <br /> ...-- - <br /> / , , ,;./, ��� � <br /> . � "s� ^ —� � � <br /> - .. - <br /> PP ...._....... t�:..�---��-�- -.............-- .... - -- <br /> A lican . <br /> Rough piping inspection _—_— - <br /> Pipe in excess of 60' _ _.-- ;Gas Stoves _ __--_ <br /> Gas refrigerators __—___- Gas water heaters � <br /> Gas space heaters to 70,000 B.T.U. input - <br /> Gas space heaters over 70,000 B.T.U. inpuh __—_ <br /> Gas fumsces to 400,000 B.T:U. input _— _ - <br /> Gas furnaces uver 400,000 B.T.U. input — <br /> Conversion units to 400,000 B.T.U. input —_— <br /> Conversion units over 400,000 B.T.U. input _--_ <br /> Small appliances—���� <br /> O" r � <br /> -- . . ,.. � . / �D- <br /> Call BackJnspectip _ _ -Fee Paid $ <br /> _ ,__Applicant <br /> sy,_;:� ��—_. -------- <br /> Pians"approved and Permit g�tanted as �equested hemin. <br /> ` , <br /> _;.. ,.. / <br /> --- ':--, ��..:_,=f��Z..E��---Inspector <br /> Gy/ _ _� _ ; `��r; -- -- <br /> �f <br /> PERMIT I�I" 43�'� <br />