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CITY OF EVERETT <br /> Application and Gas I�istallation Permit <br /> All Work to be Done in Accordance'with � <br /> City Ordinance <br /> Everett, Washingtnn......:�:,. ......-�. � ..1......, 19La.).. <br /> Lo[ation.......�..L..c1..�..��`/. .�.�...A`�_.l�?.c.�1..'.1.K.�................... � <br /> . .�, . . ._.._._.. . ... . <br /> Owne r........�...;7��7.:........ .?.L�............................. <br /> . . ,, . U �. ., ,:. , �..i��, . ... <br /> Applieant...._���:??Cb.e'!.-f..t`.!t.....'x�.'...:...........--...._. <br /> Rough piping ir�sprction � - <br /> Pipe in excess of 60' _ _ Gas Stoves _ _ <br /> Gas refrigerators _ _ Gas water heaters . <br /> Gas space hcaters to 70,000 B.T.U. input _� <br /> Gas spacc hcaters ovcr 70,000 B.T.U. input _ . .. . <br /> Gas furnac�s to 400,000 B.T.U. input . _ _ _ _ <br /> Gas fumaws over 400,000 D.T.U. input _ _ <br /> Conwrsion units to 400,000 B.T.U. input —_ __ <br /> Conversion units over 400,000 [3.T.U. input <br /> Small appliances- — _ .. __- . _ _ .—._ _. , <br /> - —-----"--. ... .. _ .---- -----'--7��-' <br /> Oa <br /> Call Back Inspection —._—__ Fee Paid$__�� <br /> � � <br /> �:,.--- -- - — -- ---'- - - - . _ -.: _. Applicant <br /> QYtt �'- r ��' �'- � _ _ _ tt -- . <br /> Ptans'approved and Permitgranfed`as icquested lierein. <br /> , <br /> _ _ ����' �' - Inspector <br /> �7' � � ��� ' - � — <br /> PERMIT Ie�° :�"�!5 <br />