HomeMy WebLinkAboutWORK ACCEPTANCE FORM K & S ENTERPRISES LLC - 21-00075 - Winder Station - New Commercial - Bldg 5Contractor 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
K & S Enterprises LLC
Kevin Clay
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
kevnsuzy6@gmail.com 208-403-5990
Mechanical (HVAC)1184 2/28/2024 3,500.00$
Permit Information
Please enter in the following format: 00-00000
21-00076 Winder Station
RP05N39E016632
Acceptance
Sign 1/18/2022