HomeMy WebLinkAboutWORK ACCEPTANCE FORM WHITESIDES PLUMBING CORP - 19-00062 - Maverik - Exterior & Interior 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 acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature Date
Contractor/Subcontractor
Whitesides Plumbing
Christian Whitesides
City
Morgan
State / Province / Region
UT
Postal / Zip Code
84050
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
60 S. 300 W.
Address Line 2
cswhitesides@gmail.com 801-301-9342
Plumbing PLB-C-12444 7/31/2019 7,947.71$
Permit Information
Please enter in the following format: 00-00000
19-00062 Maverik
75 North 2nd East
Acceptance
Sign 5/10/2019