HomeMy WebLinkAboutWORK ACCEPTANCE FORM S&D MOBILE HOME SETUP SERVICE - 21-00242 - 320 Bluebell St - Mobile HomeContractor 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
s &d mobile home setup service
daniel kangas
City
Nampa
State / Province / Region
Idaho
Postal / Zip Code
83687
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
7605 E Amity Ave
Address Line 2
dak.mmk.14@q.com 2088667826
2088667826
Building sc 597 3/30/2022 2,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00242 rexberg
320 bluebell st
Acceptance
Sign 4/18/2021