HomeMy WebLinkAboutWORK ACCEPTANCE FORM DOUG'S REPAIR (MECHANICAL) - 17-00479 - 591 Turin Way - Cantamere - Bldg 18 (21) - 4 PlexContractor 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
Doug's Repair
Misty Taylor
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
418 N 4014 E Ste #4
Address Line 2
info@dougsrepair.com 2083569331
Mechanical (HVAC)HVC-C-5600 8/31/2020 76,800.00$
Permit Information
Please enter in the following format: 00-00000
17-00477 Cantamere Village Bldg #16 - 19
591 Turin Way
Acceptance
Sign 6/10/2020