HomeMy WebLinkAboutWORK ACCEPTANCE FORM BRIAN HILL PLUMBING & HEATING - 19-00631 - Daniels - 685 Wheatland Dr - New 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
Brian Hill Plumbing & Heating
Brian Hill
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
104 S Hidden Valley Rd
Address Line 2
bhill343@gmail.com 208-390-4239
Plumbing PLB-C-12812 10/31/2021 9,000.00$
Mechanical (HVAC)C-1673 12/31/2020 18,700.00$
Permit Information
Please enter in the following format: 00-00000
19-00631 David Daniels
685 Wheatland Dr
Acceptance
Sign 11/13/2019