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HomeMy WebLinkAboutWORK ACCEPTANCE FORM FREEDOM HEATING - 21-00260 - RP05N38E155429 - New SFR MechanicalContractor 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 Freedom Heatin Rene Contreras City Idaho Falls State / Province / Region ID Postal / Zip Code 83405 Country Update new contact information that is not already on file with the City of Rexburg Street Address PO Box 51966 Address Line 2 freedomheatinginc@yahoo.com 208-339-0605 Mechanical (HVAC)6127 9/19/2021 $ Permit Information Please enter in the following format: 00-00000 21-00260 Stanger RP05N38E155429 Acceptance Sign 4/22/2021