HomeMy WebLinkAboutWORK ACCEPTANCE FORM LEISURE TIME INC - 20-00150 - 255 Nez Perce Ave - Kitchen/Living Room 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
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 8013764392
Mechanical (HVAC)005885 5/31/2020 2,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00150 Bahr
255 Nez Perce Rexburg, ID 83401
Acceptance
Sign 4/3/2020