HomeMy WebLinkAboutWORK ACCEPTANCE FORM WADE CONSTRUCTION - 20-00308 - 59 S 4th W - 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
Wade Construction
Gerry Wade
City
Tetonia
State / Province / Region
Idaho
Postal / Zip Code
83452
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
5906 Crestview
Address Line 2
gerrywade55@gmail.com 208-317-4014
Building RCT38958 3/19/2021 $
Permit Information
Please enter in the following format: 00-00000
20-00308 Wendy Stoker
59 S 4th W
Acceptance
Sign 5/27/2020