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CITY OF EVEREYT <br />Application and Gas Insfallafion Permit <br />AIl Work to be Done in Accordance with <br />City Ordinance <br />� � ��' .y. ..� . '. ✓ <br />Everett, Washington....:..i...�...t....I..,� ................ 19�U... <br />Location...........�.a�..r�. f2....l..�.....�.ct�.<'. �...... <br />_ i '� <br />9 -1, <br />Owne r.......... : �f �n ...::..:...:..T.�.:e. :�4-c�-:r.Y:� .......---- <br />. _ :'� <br />. ' . . ' � . �`��. �. ,. <br />Apphcant..;........LrS.... ...� ..................... - ..................... <br />Rough piping inspection _x _ <br />Pipe in excess:of 60' _-- Gas Stoves _____ <br />Cas refrigerators ____ _._ , Gas water heaters ___�i— <br />Gas space hcaters to 70,000 B.T.U, input —h__ <br />Gas space heaters over 70,000 B.T.U. input __. __ <br />Gas furna�es to 400,000 B.T.U. input _. ___ __ __ <br />Gas turnaces over 400,00O...D.T U, input _ _ <br />Conversion units to 400,OOG B.T.U. input __ _ <br />Conversion units over 400,000 B.T.U. input ___ <br />Small applianws____—___,___�_�.______ <br />_.— ..----..�, «— ___ � --- <br />Call Back Inspection. __.�_.� Fee Paid $_� _, �^ <br />._...-----�--------- - --�------APR,licant <br />T � � � � � <br />By_ ._-.��'���.--�r—� ------- <br />Plans approJed and Permit granted as�requested hcre�n. <br />� `� . <br />.. - - --. .���'� .. _Inspector <br />� y� �- - - <br />�>�- ---- -- - -"—� ilt'_/ --- -�------- <br />PERMIT ',� ,, .,; ,, <br />