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CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Work to be Done in Accordance',Witfi <br />Gity Ordinance <br />� <br />Eve ; �{� / �. � ! <br />�rntt, Washingion......,._ �4rM.,S.....�.�......., .19�'../.. <br />Loca t i on.....��z l L�.�o-�:���'4.-r......... <br />....... .. <br />. . ..-� _. ... �... _I�.. . ..i... . .._ . <br />Owncr..:...-lh�-[S§?h��a.:: �•�u-uc�.q,��� <br />) -- . .... ._.._....._ . ... . . ........ <br />l�ppl icanL.:..'.:... f..!:.rC!. :.:.' �... ......_ .......................... _.. <br />Rough piping inspection. x __ <br />Pipe in excess of.60'..._.,_,. _ Gas Stoves ._ <br />Gas refrigerators __ _ _____ ,Gas water heatera_%` <br />Gas sp: a heatcrs to 70,000 B.T.U. inpuY X <br />•�. __ <br />Cas . :e heaters over 70,000 B.T.U. input _ <br />Gas ?,imaces .to 400,000 [3.T.U. input —. <br />Gas furn�ces ovcr d00,G00 D�T.U. input — -_ <br />Cenversion units to 400,000 B.T.U. input <br />Conversion i,nits ov2r 400,000 Ci.T.U. input ___. <br />Small appliances--_- _.—.------_ ___ —_— -.- <br />—1: <br />-- -._....�_._ .___.�._... � r� _.. _ <br />Call Back,lnspectien _._.__�__..Fee Paid $ � .. <br />• � .r <br />;,,.._..�.._.�. �.� --- -. .____._.Applicant <br />� y.. ,, <br />a N�� �;. �:�.- 3�f i <br />..___ .. ____ .� _.__ . _. -- - —._ . <br />—, - - - <br />pi�ns approved and Pe�mit granted'as,Jequesied herein. <br />- — - �3.�✓-�`:,��--- -Inspcclur <br />�� (F' 1��- — - <br />PERMIT �'.' � � �-, <br />