HomeMy WebLinkAboutWORK ACCEPTANCE FORM YOST GALLAGHER CONSTRUCTION LLC - 22-00523 - Northwest Farm Credit Services - 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
Yost Gallagher Construction LLC
Jerry Potter
City
Spokane
State / Province / Region
WA
Postal / Zip Code
99202
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
1803 E Springfield Ave
Address Line 2
jerry@yg-construction.com 5095358874
2084469627
Building RCE-41528 3/15/2023 530,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00523 Northwest Farm Credit Services-Remodel
1036 Erikson Dr
Acceptance
Sign 8/29/2022