HomeMy WebLinkAboutWORK ACCEPTANCE FORM BIG D CONSTRUCTION CORP - 19-00136 - Romance Theater - Remodel Phase 1Contractor 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
Big-D Construction
Matt Blomquist
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
343 E 4th N, Suite 112
Address Line 2
P.O. Box 794
matt.blomquist@big-d.com 2084972734
Building PWC-C-11783 10/31/2019 151,055.00$
Permit Information
Please enter in the following format: 00-00000
19-00136 Romance Theater Phase 1
2 E Main St. Rexburg, ID 83440
Acceptance
Sign 5/23/2019