HomeMy WebLinkAboutWORK ACCEPTANCE FORM JUDCO -20-00808 - OPTIXS - 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
Judco, Inc.
Misty Crain
City
St. Anthony
State / Province / Region
ID
Postal / Zip Code
83445
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
2453 E 400 N
Address Line 2
mcjudco@gmail.com 208-624-1461
208-313-6247
Mechanical (HVAC)014820 4/30/2022 14,800.00$
Permit Information
Please enter in the following format: 00-00000
20-00808 142 W 1st North
142 W 1st North; Rexburg, Idaho
Acceptance
Sign 10/16/2020