HomeMy WebLinkAboutWORK ACCEPTANCE FORM KO PLUMBING - 19-00401 - Pizza Hut - Tenant 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
KO Plumbing
Ben Hix
City
Idaho Falls
State / Province / Region
IDAHO
Postal / Zip Code
83402
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
840 Mercury ave
Address Line 2
benrhix@gmail.com 208-821-7226
Plumbing 017662 3/31/2020 26,000.00$
Permit Information
Please enter in the following format: 00-00000
19-00401 Pizza Hut
136 w Main St
Acceptance
Sign 11/20/2019