HomeMy WebLinkAboutWORK ACCEPTANCE FORM HOUSLEY PUMPS INC - 19-00036 - 118 N 1st E - Ferguson SFRContractor 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
HOUSLEY PUMPS INC
RICHARD HOUSLEY
City
ST ANTHONY
State / Province / Region
IDAHO
Postal / Zip Code
83445
Country
FREMONT
Update new contact information that is not already on file with the City of Rexburg
Street Address
40 W MAIN
Address Line 2
hpumps@netscape.net 208-624-3772
208-390-0313
Plumbing PLB-C-9265 2/28/2021 2,000.00$
Mechanical (HVAC)HVC-C-1146 2/28/2021 1,800.00$
Permit Information
Please enter in the following format: 00-00000
19-00036 FERGUSON
118 N 1ST E
Acceptance
Sign 10/14/2019