HomeMy WebLinkAboutWORK ACCEPTANCE FORM FIRE & ICE HVAC LLC - 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
Fire & Ice Heating & Air Conditioning LLC
Cassidy Brower
City
Rigby
State / Province / Region
Idaho
Postal / Zip Code
83442
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
3821 E 120 N
Address Line 2
cassidybrower17@gmail.com 435-213-6531
Mechanical (HVAC)81-4962498 8/31/2021 8,500.00$
Permit Information
Please enter in the following format: 00-00000
20-00308 Wendy Stoker
59 So 4th West
Acceptance
Sign 6/1/2020