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City of Everett <br />Datc ' <br />Gas Installation PF:rmit <br />DEPARTMENT OF PUBLIC WORKS <br />Appliances No. <br />Convcrsion Units <br />tu A00,000 B7Us <br />ConveRmn Unils <br />over 400,000 eTUs <br />LOOI(510VC5 � <br />Range Tops — Ovens <br />Fumaces to 400000 5TUs <br />Furnaci�s ovar 400,000 BTUs <br />Spacc Heatcrs to 70,000 BTUs <br />Space Heamrs ovcr 70,000 BTUs <br />Fireplaec Lag <br />Wamr Heaters <br />PiPma <br />P�pc in encess O( 60' <br />�:IOi11C5 ��y�fS <br />Alr Conditioning Units <br />RoJnr <br />Permit Pee . . . . .� . <br />Address <br />�WnCf <br />Installer � <br />City of Everet� <br />-IMPOFiTANT NOTICE- <br />All work must conform ro the provisions uf the ortiinancr,s ol ihe CiiV oi Everetr. <br />Washing�on. I is ihe n�sponsihJilV ��t ihn Pcimit Holder Io 5ee Ihat Gry Inspection <br />Division is noiified and ihe iiuLul,Non insp���:icd hefore cuvniing. <br />Rmnnrks and Concrum:s�. <br />Inspection — Date __ Inspector -. <br />Call Back — Date Inspector - <br />Final — Date Inspector ___ ______ <br />Thiti 1'nnnit must bc posted on Job 6etore Startinn Installaii�.m. <br />R�rmit <br />