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HomeMy WebLinkAboutWORK ACCEPTANCE FORM COFFIN DEVELOPERS LLC - 22-00332 - Rexburg FM Office - RemodelContractor 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 Coffin Developers LLC Nathan Coffin City Pocatello State / Province / Region ID Postal / Zip Code 83204 Country United States Update new contact information that is not already on file with the City of Rexburg Street Address 1020 Shale Drive Address Line 2 Pocatello, ID coffindevelopers@gmail.com 12082415401 Building RCE-44124 4/5/2023 70,018.00$ Permit Information Please enter in the following format: 00-00000 22-00332 Rexburg FM Office 434 E 2nd N Rexburg, Idaho 83440 Acceptance Sign 8/5/2022