HomeMy WebLinkAboutWORK ACCEPTANCE FORM POWERHOUSE RETAIL SERVICES LLC - 25-00586 - Walmart - Revised Layout (3)Contractor 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
Powerhouse Retail Services LLC
Powerhouse Retail Services LLC- Josh Hargrave
City
Crowley
State / Province / Region
TX
Postal / Zip Code
76036
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
812 S Crowley Rd Ste A,
Address Line 2
permitting@powerhousenow.com 8172978575
817-291-1956
Building RCE-42839 8/31/2025 85,000.00$
Permit Information
Please enter in the following format: 00-00000
00-00000 Walmart
1450 North 2nd East Rexburg ID
Acceptance
Sign 9/13/2024