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CITY OF EVERETT <br />ppplication and Gas Installation Permit <br />All Work to be Done in Accordance'wi�h ` <br />City Ordinance <br />� � , / <br />(J il� : ............:...:. 1 Su'.:1... <br />Everett, V��ashington:.......:�-.. <br />/0 3 3 ' � ....:..�............ <br />._........ <br />Location..............._..................... ___. <br />. ._ . . . �... <br />i, � , .:'l:• _ ......................_. <br />APPer...........�Y(.1tz�....... .i:.. � <br />Own <br />,., ,,, / <br />_..._.._._. <br />Iica nt...........!.. �..�1....-'-- .. ................. <br />Rough pipinc� inspection - - <br />plpe in excess of 60' _-- Gas Stoves �( <br />Gas.refrigerators _- - -- �Gas water heaters--L�_ _ <br />Gas.space heaters to 70,000 B.T.U. input __--- -- <br />Gas spacc heaters over 70,000 B.T U. input _-- - <br />Gas furnaces To 400,000 B.T.U. input _— — <br />Gas furnaces over 400,OPO� B�T:U. input ._— - <br />Conversion units ic 400,000 B.T.U. input - <br />Conversion units over 400,000 B.T.U. input - <br />Small appliances- --- <br />-�'--- - — - --rt`"_'- <br />Call Back � <br />(lnspection _ _- Fee Paid 5- f .�.'�-�--�- <br />-_ _- -. - . ._ - - - nP,Plicant <br />.___,--- � <br />C�-Rl.L-� �7.Y �c/ (_ u_.._ _ - ' - _- <br />�Y-; :.-; ��_ - - i. <br />Plans approvcd and Permit grant�d as requested Ferci�i. <br />i+C:'�.:C9.c...�i; _ Inspector <br />, <br />Qy <br />'�-�-)/�'- -- <br />PERMIT ' T"' <br />