HomeMy WebLinkAboutWORK ACCEPTANCE FORM LEISURE TIME INC - 20-00113 - 3597 Ringel Ln - New SFR MechanicalContractor 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
Leisure Time Inc.
Taylor Mansfield
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83401
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
2200 N. Woodruff Ave.
Address Line 2
taylor.mansfield@leisuretimeinc.com 2085234633
Mechanical (HVAC)005885 3/14/2020 $
Permit Information
Please enter in the following format: 00-00000
20-00113 Fireplace
3597 Ringel Lane, Menan ID 83434
Acceptance
Sign 3/10/2020