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CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Work to be Done in Acmrdance.wi�li <br />� City Ordinance -- - <br />• . /' <br />n�ton...`-.�,.G/a'L,1........:.�....... � 19.�i..� <br />Location....� .,. ,•�. - / ,�'• },' ( <br />verett, as i <br />�. Q.l,l -..�. (.�_ ..�..ox��� • .... <br /><� <br />,; .�: <br />Owner..,.�cr�,c ...�r,r �r-Gy�� ............. <br />J (� � <br />Applicant_�.��l.a.r0... ��%f�:�_y�F9......:� R.�....... <br />1 ` <br />Rough piping inspection _�__—_ <br />Pipe in e�ccess of 6Q __ J---� ,Gas Stoves _�� <br />Gas refrigerators ______ ,Gas water heaters„�_._ <br />Gas space hcarers to 70,000 B.T.U. input _�. <br />Cas space heaters over 70,000 B.T.U. input _ <br />_ _ _. <br />Gas fumaces to d00,00fi B.T.U. input _ _ <br />Gas furnaces over 400,000 ,6,T.U. input _ <br />Conversion units to 4C0,000 B.T.U. input _ <br />Conversion units ov�r 400,000 B.T.U. input _ <br />Small appliance:.__._____ --�.-�-_ . <br />_..---� ; �---�----'-'----------- � <br />Call�3ackihtsotttion - .__--_ Fce Paid $_�Q.��±.. <br />��....----- <br />� .- �_ �Applicant <br />� f. ` <br />av ,.,��*"�- ---- -- -__ --- <br />,. .. „ <br />filans approved and P.ermit 9rented as requested herein. <br />i �C <br />� <br />- .. - ��.-�.'� `�— -`-- .-- -Inspeclor <br />i <br />Cv � �- � c=' i _ _ _ <br />PERMIi \�" �1�6�! <br />