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City of Everett <br />Date '% l -�5 <br />Appliances No. <br />Conversion Units <br />to 400,000 BTUs <br />Conversion Units <br />over 400,000 BTUs <br />Cookstoves <br />Range Taps —Ovens <br />Furnaces to 400,000 BTUs <br />Furnaces over 400,000 BTUs <br />Space Heaters to 70,000 BTUs <br />Space Heaters over 70,000 BTUs <br />Refrigerators <br />Water Heaters <br />Piping <br />Pipe in excess of 60' <br />Clothes Dryers <br />Air Cc,.ditioning Units <br />Permit Fee <br />Gas Installation Permilt <br />DEPARTMENT OF PUBLIC WORKS Inspection Division <br />Address <br />Owner <br />Installer <br />i yl� <br />City of Everett, by- <br />-1 MPOqTANT NOTICE — <br />All work must conform to the provisions of the ordinances of the City of <br />Everett, Washington. It is the responsibility of the Permit Holder to see that <br />City Inspection Division is notified and the installation inspected before <br />covering. <br />Remarks and Corrections: <br />Inspection — <br />Call Back — Date <br />Final — <br />Inspector <br />Inspector <br />Inspector <br />This Permit must be posted on Job before Starting Installation. <br />Permit <br />Rf,�l <br />