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� <br />CITY OF EYERETT <br />Application and Gas Installation Permit <br />All Work to be Done in Accordance with <br />- i.iry -0rdinance <br />�f.j� ; <br />Everett; Washington::.:. �!`.:Y::".: �..:`�y.........., 19�.'--.... <br />02 �J �.2 ��2 �/!' ,I��iE-�,-n�-�.C,�..... <br />Location..:...... ---....----� ..........::........J....... <br />Owner.._.....��..P..`..:^�.........-`-� -'�� .................. <br />�--�--- ' i <br />Appl icant..�,CCh�":u..(a�'rt.'..... � :..... . .......... ..... <br />Rough piping insper.tion <br />Pipe in excess of 60' -- Gas Stoves —�_ <br />Gas refrigereturs —_--_- ,Gas water heaters._.�_ <br />Gas space heaters tc 70,000 B.T.U._ input _--- <br />Gas space heaters over 70,000 B.T.U. input <br />_ _ __ <br />Gas furnaces to 400,000 B.T.U. input <br />Gas furnoces over 400,000 ,B�T�U, input - <br />Conversicn units to 400,000 B.T Ut.i'nput - <br />Conversion units ve 40 �S . . input <br />Small appliance _� �— ----- -- <br />Call Dack� Inspection - �f' e Paid $_.L�.�.-,— <br />--.i�?Yyg~���� �l � _��Plicant <br />i ,, <br />//'// ��x <br />By..�yr'�""7 , - ,� � - -- . . --- <br />r <br />Plens�approved and Permit g�nted as �equestediFe�ein <br />Yi <br />—_���''��-�`� •" _Inspector <br />__ T�._� '_ _ <br />B _ � i {L--' - - . <br />Y - <br />PERMIT �<� ° �� - � -t <br />