HomeMy WebLinkAboutWORK ACCEPTANCE FORM CHAD BALL CONSTRUCTION - 23-00599 - 3521 N 500 E - New SFR MechanicalContractor 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
Chad Ball Construction Inc
Chad Ball
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
US
Update new contact information that is not already on file with the City of Rexburg
Street Address
445 W Haven Loop
Address Line 2
chadbalconstructionoffice@gmail.com 208-390-7060
Plumbing RCE-11524 1/24/2024 $
Permit Information
Please enter in the following format: 00-00000
23-00599 Andrews
3521 N 500 E
Acceptance
Sign 10/30/2023