HomeMy WebLinkAbout19-00258 Contractor Info Form Stevens & Associates, Inc..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
Stevens & Associates, Inc.
Norman Stevens
City
Riverton
State / Province / Region
Utah
Postal / Zip Code
840652226
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
13132 S 2420 W
Address Line 2
normanezrastevens@gmail.com 8013527873
8013474727
Mechanical (HVAC)1446263-5501 11/1/2021 8,000.00$
Permit Information
Please enter in the following format: 00-00000
19-00258 White Sparrow Country Store
7875 South 1800 West
Acceptance
Sign 5/8/2019