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CITY OF EV[RETI' <br />ApRlication and Gas Installation Permit <br />All Work to be Done in Acco.da�ce with' ` <br />i �,., , - City Ordinance <br />" ',; � +. , <br />- <br />Everett, \Nashington-----_�.��::�x i---..!...'.�..: ...... , 19`y` <br />, <br />Location.._J..r.�.� � � <br />- .......-" --��-� .. ................ ..----�- <br />`� . Y�'1 �-�w.�e..�. _ <br />Owner.......,.!�'.Y.�!:6. ..............!.......---.....--�- - �-- ............. <br />, r <br />Applicant..i..i��...�:.�..I . . � . . ............. <br />............................:... ... <br />Rough piping inspection _.— ��. _ <br />Pipe in ercesi'ofy60' `_`-�r _- - Gas Stoves _-_ <br />I <br />Gas refrigerators _.___ Gas water heaters. . <br />Gas space heaters to 70,000 4.T.U. input __ — f� - <br />Gas space heaters over 70,000 B.T.U. input <br />Gas fumaces to' 400,000 B.T.U. input <br />Gas furnaces over 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 />Call Back InspecN n_ __ Fee Paid 5- �.� <br />-- [' <br />_.: _ . . _ _ _ � J APPlicant <br />r r�' c <br />By.. ;---� - -- -- L,+1.+.C.QL�_/.-7- �- --�' -'--�Y-- — <br />Plans approved and Permin grantedas mquested'here�n. <br />.�-, �� <br />-- - �i�'A��'l�j:J..': '�.'�' _ ._ _Inspectcr <br />By <br />PERMIT �`�`� �'����� <br />� <br />