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d <br /> CITY OF EVERETT <br /> Applicstion and Gas Installation Permit <br /> All Work to be Done in Accordance with <br /> City Ordinance <br /> . <br /> �7� i� . _ ,r. <br /> Everett, Washington......,;!/..c(:�<:::!�...�.:`...., 15�:".'. <br /> : <br /> ,, , � ,.- �< , q <br /> Lowtion •'/ „ �...�.4:.?:.�.�.r..�.. <br /> �.....:................ .................... <br /> ,� �, . .. <br /> �:: C.., � .l� T��. ; , ..,�.. ..: �' <br /> , <br /> Ownec..................a'-�'-------•-•-�•----.•--..::'..........,.....-�........ <br /> � ' �''l� <br /> � <br /> Applicant ..:.��`..'..:....:... ����.....................�----- ........_.... <br /> Rough piping inspection_—___ <br /> Pip� in excess of 60' _____ _ Gas Stoves ___ -__ <br /> Gas refrigerators___ __ _ Gas water heaters._x` <br /> Gas space heaters to 7G,000 Q.T.U. input _________. <br /> Gas space heaters over 70,000 B.T.U. input ___ _ __ _ <br /> Gas furnaces 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 appfiances_ __. __________ <br /> - -- �u-- <br /> , �.i. <br /> Cail Back Inspection _ Fee Paid $�;" <br /> --- --- i--- — Appl�cant <br /> i <br /> BY i 7/ U Gi.aLr+�— --- — <br /> V <br /> Plans approved and Permit granted as requested Feiein. <br /> �y <br /> ' f " /1 l�'•"C. <br /> "' " ' - � � _ __Inspettor <br /> By_ ;' �'-= t". <br /> . <br /> ___-�4 � - ---- -- <br /> PERMIT :' � �� =i <br />