Laserfiche WebLink
c�ry of ��o.�rf <br />Date � <br />Appliances . ..___ _ 'I_ No. <br />Cemcrsion Units <br />�0 400,000 BTUs _ <br />Ccnversion Units I <br />over 400,000 BTUs <br />Ccakstoves <br />Ranpc Tcps — Ovens _ , <br />Furnoces to 400AC0 6TUs '�'/"- � <br />Furncccs over 40Q000 (3TU> — <br />Spocc Hmtcrs ro 70,000 BTUs � <br />-� — <br />Space Hcatcrs ovcr 70,000 6TUs I <br />Ref rigcmtars <br />Watcr Hectcrs <br />Pipin9 <br />Pipe in excess af 60' � <br />Ciothes Drycrs I <br />Air Condilioning Units I <br />Pcrmi'; Fec . . . $ <br />Cc�s Ins4a�ic��feon Per�e�.c <br />DEPARTMENT OF PUBLIC WORK$ Inspection Division <br />r _ <br />Address . — `� �-c�"�-'L:: = <br />Owner._ -_ � /�-I •,�-t . _— --- <br />Installer_—��?_�::7�'�:'��'./_ �3-.i`7"� <br />Cityof Evere�t, bv-_—____ ____ ' <br />_I �A D(,bT A t�r �i� i � �,c <br />All work must conform Po the provisions of the ordinances of the City o( <br />Everet�, W�r:li�]�i,,�tcn I; 5 thc respcnsibllify of the Pennit Holder lo see tliat <br />Cily ins �:li�.i 1� i n I. •i��ti(i.-,d „r,cl ih�; in;tall.ilinn u c��ctcd b::t�:e <br />covering. <br />RBflldf��5 .)rr� _�nT.'r;���n5� <br />InSpection — Date Inspector __ __ _ <br />Call Back — Date _ Inspector _ <br />Final — Date _ Inspeclor ___ _,_ <br />This Permit must be posted on Job before Starting Installation. <br />Permif <br />