HomeMy WebLinkAboutWORK ACCEPTANCE FORM CENTENNIAL PLUMBING - 19-00604 - America First Credit Union - 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
Centennial Plumbing
Jeremy Fyfe
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
PO Box 486
Address Line 2
jfyfe.centennialplumbing@hotmail.com 208-317-8702
Plumbing PLB-C-12504 8/31/2021 5,825.00$
Permit Information
Please enter in the following format: 00-00000
19-00604 America First Credit Union
510 North 2nd East Suite 3 Rexburg ID
Acceptance
Sign 10/24/2019