HomeMy WebLinkAboutWORK ACCEPTANCE FORM ULTIMATE STEEL ERECTION - 21-00656 - 2911 S Frontage Rd - Carpet DirectContractor 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
Ultimate Steel Erection
Trever Poulsen
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
US
Update new contact information that is not already on file with the City of Rexburg
Street Address
2621 S. Frontage Road
Address Line 2
trever@ultimatesteelerection.com 2083564239
Building RCE-18785 10/17/2021 2,000,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00656 Carpet Direct
Frontage Road
Acceptance
Sign 8/20/2021