HomeMy WebLinkAboutWORK ACCEPTANCE FORM 24 HOUR HEATING - 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
24 Hour Heating
Steven Dick
City
Sugar City
State / Province / Region
Idaho
Postal / Zip Code
83448
Country
Madison
Update new contact information that is not already on file with the City of Rexburg
Street Address
450 S. 3rd W.
Address Line 2
24hourhtg@gmail.com 2087162219
Mechanical (HVAC)hvc_c-6068 5/28/2021 60,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00108 IBA Dance Studio
155 E 2nd N Suite 101 & Suite 102
Acceptance
Sign 3/2/2021