HomeMy WebLinkAboutWORK ACCEPTANCE FORM JAG ENTERPRISES - 20-00878 - Crestwood Apartments - Water LineContractor 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
JAG ENTERPRISES
ALAN SMITH
City
POCATELLO
State / Province / Region
ID
Postal / Zip Code
83201
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
2274 JACQUELINE LN
Address Line 2
accelpave@yahoo.com 2082448118
Plumbing 017868-c-4 12/31/2020 8,000.00$
Permit Information
Please enter in the following format: 00-00000
20-00878 Crestwood apts
235 south 1st east
Acceptance
Sign 11/5/2020