HomeMy WebLinkAboutWORK ACCEPTANCE FORM JARED KLINGONSMITH - 21-00108 - Idaho Ballroom Academy Dance Studio - 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
Jared Klingonsmith Skilled Carpentry
Jared Klingonsmith
City
Rexburg
State / Province / Region
Idaho
Postal / Zip Code
83440
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
536 Angela drive
Address Line 2
jwklingonsmith@aol.com 2082012995
Building RCE-32223 8/2/2021 40,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00108 Idaho Ballroom Academy dance studio
155 E. 2nd N.
Acceptance
Sign 2/25/2021