HomeMy WebLinkAboutWORK ACCEPTANCE FORM S&D MOBILE HOME SETUP - 23-00357 - 632 Lilac St - Mobile HomeContractor 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
s&d mobile home setup
daniel kangas
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
dak.mmk.14@q.com 208-866-7826
Plumbing mfg install 597 3/31/2024 25,023.00$
Permit Information
Please enter in the following format: 00-00000
23-00357 mobile home hookup
632 lilac st
Acceptance
Sign 6/19/2023