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CITY OF EVERETT <br /> Application and Gas Installation Permit <br /> AIl Work to be Done in Accordar.ce with <br /> City Ordinance <br /> Everett, Washington........�:C'�...�.t�............. 19.._.::I <br /> Location........ -���..L.:�--' � .............- <br /> ........ .. - <br /> r ^��..... /^ <br /> Owner.............:.::..1.fi::�: / c <br /> . r�_.........:.{�'. *' � .f..:4!�u-'�.r..... <br /> ......... ...... <br /> - . ..f �- rt. <br /> Applicant...........:::'...:..-- -.....,-......-�---�----.... . <br /> . ............_... <br /> Rough piping inspection ____ _ <br /> P�pe in excess of•60' _ Gas Stoves _ _ <br /> � _ _ <br /> Gas refrigerators ._____ _ Ga, water heaters <br /> r <br /> Gas space he�,ter, to 70,000 B.T.U. in�;ut __�_. <br /> Gas space heaters over 70,000 B.T.U. input _ <br /> Gas iurnaces to 400,000 B.T.U. input __ <br /> Gas fumaces over 400,000 B.T.U. input <br /> Conversion units to 400,000 B.T.U. input _ _ <br /> Conversion units over 4J0,000 B.T.U. input <br /> Small appliances__ _ __,___ <br /> ------ --- /(��,. . <br /> Call Back Inspection __ ___ Fee Paid $_ ___.. ___, <br /> � <br /> --..-�----- -- � ------- - -APPlicant <br /> '� � ,� `+S: r , .. � <br /> By:. ..-�- _L:._�L�C — =� �-�� <br /> flan; approved and Fermit grantec' a4 requested'herein. <br /> '-' � - <br /> - LL--;�'L..S:` 4 %n'_j-` "��`---- .. _Inspector <br /> ___ / _ , <br /> Dy I- - _ <br /> PERMIT ` T� ; <br /> � <br /> � <br />