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CITY OF EV=RETT <br />Appljcation and Gas Installation Permit <br />All Work to be Done in Accordante witN'` <br />r . <br />� City Ordi�ance - <br />c i .:, /t/ ' �—^ <br />Everett, Washington:.:::..:��....: T :::::::::...:..: 19:�.J: <br />Looation..........':..I Sj 0 �l %�w'c^^-."/ <br />� <br />...... ..... ........................... .................. <br />_ , ,.. <br />' ' P��.:�;;f . .; <br />� . '.. -�e � ` :. .. _ <br />Owner........... .. \.....'......... �-� ... ........... i .............. <br />� <br />:.:��rn.. .. . �,. � ... . ._. .. __. .......... <br />� � - � :. . ... � <br />APPlicant.. � ........::............. :....................:...::. .................. <br />Rough piping inspection _ __ <br />Pi�'in excess of 60' �-_ Gas Stoves <br />GaA rre,frigeretors ___ , Gas water heaters ---_ <br />Ga� space heaters to. 70,000 B.T,U._ input X X— <br />i .,., t <br />Gas space heaters over 70,000 B.T.U. input <br />Cas fumaces tb 400,000 B.T.U. input <br />Gas fumaces over 400,00�4,BT,:�,Iq input — <br />C�nversion units to 400,000 B.T.U. input — <br />Conversion units over 400,000 B.T.U. input <br />Smd�l appliances_ — —_—_—_—_ <br />., �, <br />Call Back lnspection ____ Fee Paid $_�� _._,,,�: <br />�:::.:;--J�`—� `-- ---'OPPlicant <br />(/-ILi�Y? � �%.2 / <br />�ytt--' � ----1 �--=—���-- <br />Plaiis �pproved and Pe'i rt jranted:es requested �hefe�n. <br />_ � � �'�+�+�'�� —Inspector <br />BY -�-��" - ---- <br />PERMIT I�T° 3:� �,;'� <br />