HomeMy WebLinkAboutWORK ACCPETANCE FORM EPIC SERVICES - 20-00053 - 124 E 2nd N Units 1 & 2 - Duplex ConversionContractor 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
Epic Services LLC
Derek Dodson
City
SUGAR CITY
State / Province / Region
ID
Postal / Zip Code
83448
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
PO Box 62
Address Line 2
epicsvcs@gmail.com 2082709470
2082709470
Mechanical (HVAC)020082 8/31/2020 $
Permit Information
Please enter in the following format: 00-00000
20-00053
Grant & Shawna Nelson Home Remodeled Into A
Duplex
124 E 2nd N Rexburg, Idaho
Acceptance
Sign 2/14/2020