HomeMy WebLinkAboutWORK ACCEPTANCE FORM QB CONSTRUCTION - 21-00332 - 1130 Stone Dr - New SFRContractor 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
QB Construction
Quinn Benson
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
qbconstruction@hotmail.com 2083135568
Building RCT-12410 11/4/2021 100,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00332 Quinn Benson
Stone Dr.
Acceptance
Sign 5/19/2021