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CITY OF EVERETT <br />Application and Gas Installation Pcrmit <br />All Work to be Done in Accordance with <br />City Ordinance <br />Everett, Wasthington::.......' 7. ."' ' ' - .... ' <br />Location._ ..............:........ <br />Owner......... a( ... ...... <br />......� <br />icuin ic`-7;i vi'/! ... <br />...................... <br />App! ican r:........l....... . <br />Rough piping inspection X - <br />Pipe in excess of 60' -- <br />Gas Stoves <br />Gas refrigerators -- Gas water heaters - <br />Gas space heaters to 70,000 B.T.U. ;nput <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 B.T.U. input <br />Conversion units to 400,000 B.T.U. input — -%----- <br />Conversion units over 400,000 B.T.U. input -. <br />Small o. <br />_.. _.,._ <br />Call Back Inspection _ -- Fee Paid-$. <br />_. _......_.Applicant <br />By <br />—1" <br />Plans approved and Permit granted as requested-hepettt• <br />F 7QIsP Inspector <br />By -- <br />PERMIT N? T"73 <br />