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HomeMy WebLinkAboutWORK ACCEPTANCE FORM BATEMAN-HALL INC - 20-00314 - Advance Auto Parts - 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 Bateman-Hall, Inc. Ben Christensen City Idaho Falls State / Province / Region ID Postal / Zip Code 83402 Country United States Update new contact information that is not already on file with the City of Rexburg Street Address 1405 Foote Drive Address Line 2 ben.christensen@bateman-hall.com 208-523-2681 208-221-7364 Building RCE-1195 12/14/2020 50,000.00$ Permit Information Please enter in the following format: 00-00000 20-00314 Advance Auto Parts 125 Valley River Road Rexburg, ID 83440 Acceptance Sign 5/20/2020