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a <br /> CITY OF EVERETT <br /> Application and Gas Insfallation Permit <br /> All Work to be Done in Accordance 'with'� <br /> t �, . City Ordinante <br /> / .1 ' <br /> Everett, WAshington...:....�C t.�`�_.{� .,., 19.�.'st <br /> - ..:. .... <br /> � r�1 <br /> Location.._.....�.�._f•"�.:"�.....,i.L.::.:..^.:r....r..:.......:....... <br /> Owner �// �j,� �p�� <br /> � A� ... : Y a <br /> f� LS...r.. <br /> i ' . 'LT 4` <br /> Applicant�;� :... ' ;, b� <br /> --� �......... .............�--.......---..... <br /> Rough piping inspection ___[_�_ <br /> Pipe in excesr of b0' :_ `�_, ,Gas Sroves _ <br /> Gas �efrigerafors _ ____ ,�s water heaters..�_._ <br /> Gas space heaters to 70,000 B.T.U. input � <br /> Gas space heaters over 70,000 B.l'.U. input _ <br /> Gas fumues tb 400,000 B.T.U. in'put _ <br /> Gas furnaces over 400,000,B�T.U. input __ <br /> Conversion units to 400,000 B.T.U. input __ <br /> Conversicn units over 400,000 B.T.U. input <br /> Small applianws________,__ _,� <br /> ---T--___-- —= ./�b <br /> Call Back(Inspection ____ Fee Paid� <br /> _� 1 -x'. ' - <br /> �..� --- 1_------- ---- APP�licant <br /> �� , . <br /> � . � - �-�----� _ _�1;�. <br /> plans approved and permii gYa'rited as requested 1Rpiein: <br /> `� � , � , <br /> - -- t�k'fc6L" �111'y�`�';��. ---_Inspector <br /> (� �=�_.�'�1 /) 7 <br /> ���-- ----—�-'---� —t --- <br /> PERMIT '�?�? ti 1 ��r <br />