HomeMy WebLinkAboutWORK ACCEPTANCE FORM MALOSI BUILDERS LLC - 22-00319 - 1268 Stone Dr - Basement FinishContractor 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
Malosi Builders LLC
Jason Murphy
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
940 S 5th W # 11108
Address Line 2
jason@malosibuilders.com 385-888-1362
Building RCE-62900 7/26/2023 $
Permit Information
Please enter in the following format: 00-00000
22-00319 1268 Stone Dr
1268 Stone Dr
Acceptance
Sign 6/30/2023