HomeMy WebLinkAboutWORK ACCEPTANCE FORM ALAN GOULD - 19-00154 - 1450 N 2nd E - Walmart - Grocery Pickup 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
Walmart Stores Inc.
Alan Gould
City
NORTH OGDEN
State / Province / Region
UT
Postal / Zip Code
84414
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
709 East 1750 North
Address Line 2
alan.gould@walmart.com 801-389-4195
801-389-4195
Fire Alarm ELE-SJ-14710 4/30/2020 2,000.00$
Permit Information
Please enter in the following format: 00-00000
00-00000 Online Grocery Pickup Expansion
1450 N. 2nd East
Acceptance
Sign 8/27/2019