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CITY OF EVERETT <br />A�piication and Gas Insiallation Pcrnit <br />All Work ro be Done in Accordance with <br />City Ordinance <br />Everert, WashingYon.:..� � �..�..........., 19._>::.:, <br />� � ,,/,� <br />r : .... .. <br />Location._...�..�..�D_ ---..x5....:....^.iY..� ...................... <br />..... <br />p, /__....`.t.. .. . <br />Owner..._.......lrk'.a:......�.!,..:Ft 4�.f�:?:{,�::.' ............._..... <br />i� �, <br />Applicar.t.t ............. �%. `i...::.i_.................:..:......__....._.. <br />Rough piping inspection _ _ _ . <br />Pipe in excess of 60' . _ Gas Sroves __ _ <br />Gas refrigerators - Gas water heaters _L�.._.._ <br />Gas space heaters to 70,000 B.T.U. input <br />Gas space heaters over 70,000 B.T.U. input <br />Gas furnaces to 400,C00 B.T.U. input ._ -_ . <br />Gas furnaces over 400,000 B.T.U. input <br />Conversion units ro 400,000 B.T.U. input _ <br />Cornersion units ove� 400,000 B.T.U. input —_- <br />Small appliances_ � <br />- - -------- ----- - - - - <br />- / CC <br />l:all 6ack Inspection _...____-_ Fee Paid 5--- _- <br />....-� --------- ---. _.--- -- - - �-'4PPlicant <br />By. __�_ti�r_. .is� � __%i�..�,� _ _ _. --• - <br />Pl.�ns approved and Permit granteu :s requested.herein. <br />� �\j,, <br />- - - -.�--C� -4-(. C.•7 -�-- - � - - -Inspector <br />7 <br />Gy _ . . ._ _if,/:�_'-- -- -- -- --- - <br />RERMiT � � <br />