HomeMy WebLinkAboutWORK ACCEPTANCE FORM LKE & SONS AG LLC - 22-00270 - 35 W Main - Remodel4/26/22, 7:06 AM New Submission
L�t�c Contractor Work Acceptance Form
Contractor/ Subcontractor
Business Name:
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Contact Name: *
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Mailing Address
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Street Address
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Address Line 2
City // State / Province / Region
Postal / Zip Code Country
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Email: * y� c /�
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Phone: * v
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Mobile:
Discipline: * License #: * Expiration Date: *
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Value of Work:
$
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4126/22, 7:06 AM
I— Add
Permit Information
Permit Number: *
Please enter in the following format: 00-00000
22-00270
Project Name: *
Tony Nielsen
Project Address:*
35 W. Main Rexburg, Idaho 83442
Acceptance
New Submission
By signing, 1 acknowledge that 1 am the indicated contractor for the above mentioned Permit/Project.
Signature
Sign
Date
4/26/2022
Submit Save as Draft
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