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City of Everett <br />Date— .... <br />Appliances No. <br />Conversion Units <br />to 400,000 BTUs <br />Conversion Units <br />over 400,000 BTUs <br />Cookstoves <br />Range Tops —Ovens <br />Furnaces to 400,000 BTUs <br />Furnaces over 400,000 BTUs <br />Space Heaters to 70,000 BTUs <br />Space Heaters over 70,000 BTUs <br />Refrigerators _ <br />Water Heaters <br />Piping <br />Pipe in excess of 60' <br />Clothes Dryers <br />Air Conditioning Units <br />Permit Fee . . . $ <br />las Installation Perm - <br />DEPARTMENT OF PUBLIC WORKS <br />Address ---- <br />Owner <br />Installer_. <br />City of Everett, by <br />r% <br />Inspection Division <br />IMPORTANT NOTICE — <br />All work must conform to the provisions of the ordinances of the City of <br />Everett, Washington. It is the responsibility of the Permit Holder to see that <br />City Inspection Division is notified and the installation inspected before <br />covering. <br />Remarks and <br />Inspection — Date���'1L Inspectord�!-J/�� <br />Call Back — Date_ Inspector_ // <br />Final — Date 1e 5' Inspectory <br />This Permit must be oosted on Job before Starting Installation. <br />Peu•.,it <br />