HomeMy WebLinkAboutWORK ACCEPTANCE FORM JARED KLINGONSMITH SKILLED CARPENTRY - 23-00729 - 257 Marianne Dr - Duplex ConversionContractor 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
Jared Klingonsmith Skilled Carpentry
Jared Klingonsmith
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
536 Angela drive
Address Line 2
jwklingonsmith@aol.com 2082012995
Building RCE-32223 6/1/2021 $
Permit Information
Please enter in the following format: 00-00000
23-00729 Debbie Dickey residence
257 Marianne drive
Acceptance
Sign 10/31/2023