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CITY OF EVERETT <br />>APplieation and Gas Installation Permit <br />All Work to be Done in Attordance with <br />City Ordinancr, <br />. .? � � � , �. <br />Everett, Washington......:....:!-.::4:�.- � � <br />_ <br />.....:...�......, 19. `�.... <br />Location / J G � t" :; ..� ,.= 7�" <br />................................... :.............................. <br />� � � � <br />' ! <br />- <br />Owner ............:.::.:`....� �:.:':::..:--.....�..:::1:::--..................... <br />.{� � <br />Appiicanf ' <br />........... ���. : :::'%.<"....:. -.--"v�-c..�� <br />� _ ,-• ................. ............................ <br />Rough piping inspection __�____, <br />Pipe in excess o( 00' ______ _ Gas Stuves _____ <br />Gas refrigerators ___ ____ Oa� water heaters _ _ <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 40C,700 B.T.U. input _____ <br />Gas fumaces over 40�,000 B.T.U. input ____ __ <br />Conversion units to 400,000 B.T.U.input _____ _ <br />Conversion Units over 400,000 B.T.U, input —___ <br />Small appliances_. __. _ <br />.•.�rc •r,i....r.�.- - — <br />_ .___—=�"'�-�---- --4— _ . <br />Call Backlnspection __.____ Fee Paid c� ~` <br />S—G' _ - .._ _._ <br />---- — - - � ------------- ----'4PPlicant <br />/ .' j <br />y_-- '��: _' .�____ .. �; <br />Plans approvad and Permit granted as rcquested herein. <br />p <br />'_ —_ _ — _ _ k�� 1':. �t'."i �. C..� . <br />----- - --�_ _ ._---- - -inspeclor <br />BY -----I — � � <br />PERMIT :;<���� <br />