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City of Everett <br />Date_ <br />Appliances No. <br />Conversion Units -I <br />to 400,000 BTUs <br />Conversion Units <br />over 400,000 BTUs <br />Cookstoves <br />Range Tops — Ovens <br />Furnaces to 400,000 BTUs <br />Furnaces over 400,000 BTUs <br />Space Heaters to 70,000 BTUs <br />Space Heaters over 70,000 BTUs <br />Refrigerators <br />Water Heaters <br />Piping <br />Pipe in excess of 60' <br />Clothes Dryers <br />Da <br />Air Conditioning Units <br />Permit Fee . , , $ <br />-1110*1-1 - --- <br />Gas Installation Permit <br />DEPARTMENT OF PUBLIC WORKS Inspection Division <br />Address _ 12LZ G 61 AbJD <br />Owner— /t/ c; /NAwON <br />Instai!er <br />City of f:verett, <br />—IMPORTANT NOTICE <br />All wo-k must conform to the previsions of the ordinances of the City of <br />Everett, Washington, It is the responsibility of the Permit Holder to see that <br />City Inspection Division is notified and the installation inspected before <br />covering. <br />Remarks and Corrections - <br />Inspection — Date.__ Inspector <br />Call Back —Date—_ Inspector <br />Final — Date // / ZY Inspector l< `C <br />This Permit must be posted on Job before Starting Installation. <br />Permit <br />..r <br />-ck i,} <br />