HomeMy WebLinkAboutWORK ACCEPTANCE FORM - CONSTRUCTION SOLUTIONS - 23-00605 - Dutch Bros - New Commercial BldgContractor 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
Construction Solutions Company
Challis Steward
City
Ammon,
State / Province / Region
ID
Postal / Zip Code
83401
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
2880 E. 14th N.
Address Line 2
eric@cscid.com 208-371-4525
Building RCE 31727 7/31/2024 1,199,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00605 Dutch Bros- New Commercial Buildings
905 W. Main Street
Acceptance
Sign 4/4/2024