HomeMy WebLinkAboutWORK ACCEPTANCE FORM EDSTROM CONSTRUCTION - 17-00474 - 591 Turin Way - Cantamere - Bldg 12 - 4 PlexContractor 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
Edstrom Construction, Inc
Jim Martin
City
Rexburg
State / Province / Region
Idaho
Postal / Zip Code
83440
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1305 S 12th West
Address Line 2
jim@edstromconstruction.net 208-356-3577
208-351-5605
Building PWC-C-10467-AAA-1-2-3 5/31/2019 1,260,000.00$
Permit Information
Please enter in the following format: 00-00000
17-00474 Cantamere Building 12
591 Turin Way
Acceptance
Sign 4/23/2019