HomeMy WebLinkAboutWORK ACCEPTANCE FORM ASCENDING JAI CONSTRUCTION - 21-00638 - Casa de Ochoa - 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
ASCENDING JAI CONSTRUCTION
Nancy Valenzuela
City
IDAHO FALLS
State / Province / Region
ID
Postal / Zip Code
83402
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
740 MOONLITE DR
Address Line 2
sserrato1978@gmail.com 2089700223
Building RCE-55949 9/14/2021 $
Permit Information
Please enter in the following format: 00-00000
21-00638 CASA DE OCHOA
383 S 2ND W STE B
Acceptance
Sign 8/13/2021