HomeMy WebLinkAboutWORK ACCEPTANCE FORM TIMELESS TILE TRADITIONS - 19-00401 - Pizza Hut - Tenant RemodelContractor 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
Timeless Tile Tradtions
Ben Mason
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83404
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1620 Daffodil Place
Address Line 2
tttraditions@gmail.com 2082215608
Building RCE-47360 5/22/2020 $
Permit Information
Please enter in the following format: 00-00000
19-00401 Pizza Hut Store #2175
136 W. Main St. Rexburg, ID 83440
Acceptance
Sign 11/19/2019