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City of Everett <br />Date / 7 T <br />Appliances <br />No. <br />Conversion Units <br />to 400.000 BTUs <br />Consersion Units <br />over 400,000 BTUs <br />Cookstoves <br />Range Tops — O n.ns <br />Furnaces to 4D0,000 BTUs <br />Furnaces over 400,000 BTUs <br />Space Healers to 70,000 BTUs <br />Space Heaton over 70,000 BTUs <br />Fireplace Lon <br />Water Heaters <br />OD <br />Piping <br />Pipe in excess of 60' <br />Clothes Dryers <br />Air Conditioning Units <br />Boiler <br />;ems. <br />Permit Fee, <br />f <br />Gas Installation Permit INSPECTION DIVISION �f _ DEPARTMENT OF PUBLIC WORKS <br />Address / / ✓� ��yy �-+ ^7 <br />Owner ` /[/C.`_ <br />Installer <br />City of Everett, by �/ •� <br />—IMPORTANT NOTICE — <br />All work must conform to the provisions of the ordinances of the City of Everett, <br />Washington. It is the responsibility of the Permit Holder to see that City Inspection <br />Division is notified and the installation inspected before covering. <br />Remarks and Corrections: <br />Inspection — Date Inspector <br />Call Back — Date Inspector <br />Final — Date Inspector <br />This Permit must be posted on JoL ::fore Starting Installation. <br />Permit 3302 <br />