HomeMy WebLinkAbout19-00371 Contractor Info Form J&S Construction Company.pdfContractor 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
J&S Construction Company
Shara Hawke
City
Rigby
State / Province / Region
Idaho
Postal / Zip Code
83442
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
739 North 3700 East
Address Line 2
jsconst@ida.net 208-754-8684
208-589-2753
Building PW # c-10082-AAA-3-4 5/31/2020 93,812.00$
Permit Information
Please enter in the following format: 00-00000
19-00371 Veterans Memorial Building Remodel
480 West 2nd North Rexburg, Idaho 83440
Acceptance
Sign 7/9/2019