HomeMy WebLinkAboutWORK ACCEPTANCE FORM CENTENNIAL PLUMBING - 17-00304 - 342 S 4th E - Basement RemodelNew Submission
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Contractor Work Acceptance Form
Contractor/ Subcontractor
Business Name:
Centennial Plumbing
Contact Name:'
Jeremy Fyfe
Mailing Address
Update new contact information that is not atready on fite with the City of Rexburg
Street Address
PO Box 486
Address Line 2
City
State I Province I Region
Rexburg
ID
Postal f Zip Code
Country
83440
USA
Email• *
jfyfe.centennialpiumbing@hotmail.com
Phone:
208-317-8702
Mobile:
Discipline: * License #: * Expiration Date:* Value of Work:
Plumbing i%ji PLB-C-12504 '813112021 $
https://iaserfiche.rexburg.org/Forzxas/C8tNQ 11/18/2019
New Submission
Add
Permit Information
Permit Number:
Please enter in the following format: 00-00000
17-00304
Project Name:
Brian Henson
Project Address:
342 S 4th East
Acceptance
By signing, I acknowledge that I am the indicated contractor for the above mentioned
Permit/Project.
Signature
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[date
.1111812019
Submit Save as Draft
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https:f/Iaserfiche.rexburg.org/Fonns/C8fNQ 11/18/2919