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NetClerk, Inc. : e-Solutions, • the contracting industry � Building <br /> xeo Drhuqur Azr,Soufh San F'rannrro, c�.9��� ' Permit <br /> 650.61}Gf25 <br /> Application <br /> 5�iq► <br /> � - � �� b � <br /> , - - - _ - -- � <br /> l p Permit Handling I.nstructions <br /> LMail _ _. __l ' Jlll.. � 6 2pp� <br /> Everett Pick UP Instructions: <br /> CITY UF EV�pE Mail To: 1-877-848-5888 <br /> Bullding DepartmeqCO���er��o,pubiic serv Cq <br /> 3200 Ced�r St - <br /> Evarelt,WA. 98201 Or mail to contractor address be%w: <br /> Maln: (425)2S7•8810 <br /> Felf:(425)257$857 prioriry is gi�rn ro peaplr at rounter.One day n�rnaround jor mailed <br /> o��s. <br /> C o n t r a c t o r I n f o r m a t i o n <br /> Company: Fasl Water Heaters Co. Worker's Comp Canler: Lurich US <br /> Address: 12601 132nd Ave. N.E. Worker's Comp Carrler N: WC2978779 <br /> Gity K!rkland,WA. 98034 Stata Contractor's Lleense N: FASIWHC052DF <br /> Phone: 425-814-3124 <br /> — — - -- - -- <br /> Fax: 1-877-848-5888 — - C'r e�d i r ('•u r r/ /n fa r iu n t i n n - - <br /> Bus. Lleense N <br /> Crodlt Cud Numb�r: - ------------ -- -- -- <br /> Nema on Card: <br /> Explratlon Date: <br /> �Vlse- -- Mastarcard <br /> -1 [--1 <br /> N o t c s / C o m m e n t s <br /> Pre•rep:NO Attachments:-SASE <br /> Payment: Check Permit Type:Paper , <br /> _ A u t h o r i z a t i o n F o r m s <br /> •A�rnt M�6erintle�"•BY�1��1 me Iofa�om heWw�pau <br /> iwAaix Np Qd41oc.ro Ka u�n�gm m yar behd(: <br /> Ta NMn�IrXeyConenn� <br /> Cer U��Imn wrAorW Nr+Ckrk Inr.sad all crosnry r�plcy�d and avtForkd <br /> anoNaro ofNtrClnRlK,b aa�ar aA o8re�on om LshafJ-tfjnfn�Jaaayo�ddl <br /> bulldn�prrMiw aJ fluuu nry4sd 6y ar ton�ony. <br /> . f , � <br /> �y L/ <br /> /.' � <br /> Nau: � S <br /> ]bk: �onf�L//i .. <br /> CmWay l�attNaprHmurCa�panY <br />