HomeMy WebLinkAboutWORK ACCEPTANCE FORM HUFCOR - 19-00047 - 358 E 2nd S - Lincoln Elementary School - AdditionContractor 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
Hufcor inc.
Alvin Head
City
Long Beach
State / Province / Region
CA
Postal / Zip Code
90805
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
2380 East Artesia Boulvard
Address Line 2
alvinhead5419@gmail.com 310-283-7991
Building 1052640 4/19/2019 $
Permit Information
Please enter in the following format: 00-00000
19-00047 Lincoln Elementary
address 358 E 2nd S Rexburg ID 83440
Acceptance
Sign 7/9/2019