HomeMy WebLinkAboutWORK ACCEPTANCE FORM MATTHEWS PLUMBING & HEATING - 18-00285 - 2300 University Blvd - Madison High School Stadium - New ConstructionContractor 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
Mathews Plumbing & Heating Inc
Mike Balmforth
City
SHELLEY
State / Province / Region
ID
Postal / Zip Code
83274
Country
US
Update new contact information that is not already on file with the City of Rexburg
Street Address
342 South State Street
Address Line 2
PO Box 464
mike@mathewsplumbing.net 2083573439
208-589-8395
Plumbing PLB-C-11778 2/28/2022 272,000.00$
Permit Information
Please enter in the following format: 00-00000
18-00285 Madison Event Stadium
Madison Hign School
Acceptance
Sign 7/23/2019