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CITY OF EVERETT <br />Applicatioq and Gas Installation Permit <br />All Work to be Done in Accordance ItvitFi'"' ` " <br />Ciry Ordinance j. - <br />� . :. , . ' <br />Everett; Washington:.:::.:....!-.�:.1•--..'5..........., 19�y.. <br />/ • , . <br />Location.....!�.SD „S A-uatitv... ��?a- .�.'..'_....... <br />_ ........... <br />_ _ <br />� �� , a i3 . <br />Owner.....---� .....................................� -- -....................... <br />A,.; ,;,,_ _ <br />PPI icant:...........�'-.".�'�,....:......`.�� . ...........:............... <br />Rough piping inspection x _— <br />Pfpe'in e�cess of.60';' - ''„Gas Stoves _ <br />Gas_,reffigerators _ ;Gas water heaters <br />Gas_space heaters to 70,000 B.T.U. input <br />,.� , �. ,,� /. _..... <br />Gas space heaters over 70,000 B.T.U. input � <br />Gas fu�nces to 400,000 B.T.U. inpul '— �-- <br />Gas furnaces over 400,000 ,B.T.U. input _ <br />., . ...� • .. .... <br />Conversion units to 400,000 B.T.U. input _ <br />Conversion units over 400,000 B.T.U. input <br />Small appliances—. _____�� .� <br />_ . � , �. <br />Call Back�'Inspection —_—_ Fee Paid $;:r� <br />. ,..-_. . +6W'_��- ��.-_ ��_Applicant <br />� �z.6 � r. z : <br />By-t , _�_� _—�__ _�.-- � �_ <br />PI'ans`approved and Permit granted as requesfed h'erein. <br />_ ��f� , <br />__ ��!t-'.�f';!�;�.__—_Inspector <br />. _.a�.�-'i1".L1L <br />Dy <br />PERMIT Id° 3?�-1 <br />