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CITY OF EVERETT <br />Application and Gas Installation Permit <br />All Work to be Done in Accordance with <br />City Ordinancc <br />,: ' '�;, • � �,' " � <br />E�erctt, Washington :.......::::.'::.:�...........x..:..---..., 19...1.... <br />L.ocation... '^� J 'Z T '1 �l�ta'Yc'S i:t-�' <br />i <br />.............................................................. <br />� .. ..�( '� -�,, ��. _._v1 _. . - <br />Owner::....:..�^`^�-�-` � /��4Ui� ................. <br />.............•-........................ . <br />, � � • <br />,, <br />� <br />,_. <br />� �. , � � <br />p "._ . ' .:��,t ��, <br />A plicanjl....::�,_...:.....?�,.....:...�..._i:..........__............ <br />Rough,piping inspection —�__ <br />Pipe in excess of�60'-��_..-.- Gas Stovcs _—____ <br />Gas refrigerators � � _ ,Gds H�ater heaters �— <br />Gas space heaters to 70,000 B.T.U. input —� <br />Gas space heaters cver 70,000 B.T.U. input <br />Gas fumaces to 400,000 B.T.U, input <br />Gas fumaces over 400�000 ByT,�U. 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 />� \qr <br />Call Back lns ection � Fee Paid$ �_� <br />� Vt J� d2 �.�-:� � � Applicant <br />�_.. _t � ---�_—� � �i <br />J' <br />- --- ---- - <br />..u.�-- ��- <br />aY �,--;------ — —, -- <br />� <br />Plahsap�3roJed and Pe�mi6g�anted as requested here�n. <br />- -- - �",{„+���:��.��'- —� ---._..Inspedor <br />Gy. . . _ . _ - - - ---- — -._ <br />PERMIT �" ��6h6 <br />