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CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Work to be Done in Accordance with <br />City Ordinance <br />/ t ."n- / 19 ... <br />Everett, Washington .................... ................ <br />... <br />tN1 .x . ........... <br />Location ......... ..f ....... <br />Owner ......................K; .... ........... e ............ <br />-A ............ <br />Applicant.._...... ...................................... <br />Rough piping inspection <br />Pipe in excess of 60' Gas Stoves <br />Gas refrigerators — Gas 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 400,000 B.T.U. input <br />Gas furnaces over 400,000 98ja 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 />Call Back Inspection Fee Paid $ <br />-...Applicant <br />3BY <br />ris-al5proved and Permit granted as requestecl 'hbrein. <br />A --Inspector <br />PERMIT N? 41S7 <br />