HomeMy WebLinkAboutWORK ACCEPTANCE FORM DOUG'S CONSTRUCTION & REPAIR - 21-00780 - 111 E 2nd N - Units 1 & 2 - Duplex ConversionContractor 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Doug's Construction and Repair Inc
Misty Taylor
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442-5369
Country
United States of America
Update new contact information that is not already on file with the City of Rexburg
Street Address
418 N 4014 E
Address Line 2
Ste 4
info@dougsrepair.com 208-356-9331
Plumbing PLB-C-13418 2/28/2022 4,100.00$
Permit Information
Please enter in the following format: 00-00000
21-00780 Nini Anderson
111 E 2nd N
Acceptance
Sign 11/9/2021