HomeMy WebLinkAboutWORK ACCEPTANCE FORM SUPREME PLUMBING - 19-00745 - Webb - 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
Supreme Plumbing
Juan Luna
City
Shelley
State / Province / Region
Idaho
Postal / Zip Code
83274
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
1175 N 1350 E
Address Line 2
supremeplumbing208@yahoo.com 208-497-1270
Plumbing 020475 2/28/2022 9,600.00$
Permit Information
Please enter in the following format: 00-00000
19-00745 Big Bend
Not known
Acceptance
Sign 12/9/2019