HomeMy WebLinkAboutWORK ACCEPTANCE FORM COZY NIGHTS FIREPLACES - 19-00150 - 617 W 7800 S - FireplaceContractor Work Acceptance Form
Business Name:*
Contact Name:*
Mailing Address
Email:*Phone:*
Mobile:
Discipline:*License #:*Expiration Date:*Value of Work:
Permit Number:*
Project Name:*
Project Address:*
By signing, I acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature
Date
Contractor/Subcontractor
Cozynights Fireplaces
Darin McDonald
City
Idaho falls
State / Province / Region
Idaho
Postal / Zip Code
83401
Country
Bonneville
Update new contact information that is not already on file with the City of Rexburg
Street Address
3785 e 109 n
Address Line 2
darinmcdonald780@yahoo.com 208-313-4478
Mechanical (HVAC)009665 5/31/2021 4,500.00$
Permit Information
Please enter in the following format: 00-00000
19-00150 Lynn Nelson
617 W 7800 S
Acceptance
4/2/2019