HomeMy WebLinkAboutWORK ACCEPTANCE FORM DOUG'S REPAIR - 19-00706 - 110 E Main St - Water LineContractor 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
Doug's Construction and Repair Inc
Misty Taylor
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
418 N 4014 E
Address Line 2
Suite #4
info@dougsrepair.com 208-356-9331
208-351-6400
Plumbing RCE-36214 10/22/2020 5,000.00$
Permit Information
Please enter in the following format: 00-00000
19-00706 Radix
110 E Main St
Acceptance
Sign 11/19/2019