HomeMy WebLinkAboutWORK ACCEPTANCE FORM PACIFIC SUNDANCE CONSTRUCTION INC - 22-00636 - Temple View Care Center - Shower RemodelContractor 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
Pacific Sundance construction inc.
douglas benson
City
Laguna nigel
State / Province / Region
California
Postal / Zip Code
92677
Country
Usa
Update new contact information that is not already on file with the City of Rexburg
Street Address
32451 Golden Lantern Suite 204
Address Line 2
dougb@pacificsundance.com 8017599711
8017599711
Building RCE-25610 5/27/2024 155,999.00$
Permit Information
Please enter in the following format: 00-00000
22-00636 Temple view care center - shower remodel
660 south 2nd west
Acceptance
Sign 12/18/2023