HomeMy WebLinkAboutWORK ACCEPTANCE FORM DAVID B EVANS - 20-00489 - Rockwell House - 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
Dave Evans
Dave Evans
City
richland
State / Province / Region
WA
Postal / Zip Code
99354
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
1217 STEVENS DR
Address Line 2
evansdavid505@yahoo.com 541-965-9891
Electrical 046657 6/30/2023 15,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00494 Rockwell House
431 S 2nd W
Acceptance
Sign 7/8/2020