HomeMy WebLinkAboutWORK ACCEPTANCE FORM GRUTES CONSTRUCTION - 22-00755 - 1196 Castle Pines Rd - New SFRContractor 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
Grutes Construction
Gordon Speakman
City
Firth
State / Province / Region
Idaho
Postal / Zip Code
83236
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
726 E 700 N
Address Line 2
gspeakman123@gmail.com 2082706910
Building RCE-57123 2/3/2023 $
Permit Information
Please enter in the following format: 00-00000
22-00755 Pinebrooks Estates Home
Lot 24-b6 Castle Pines Road
Acceptance
Sign 10/11/2022