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HomeMy WebLinkAboutWORK ACCEPTANCE FORM TC PLUMBING - 19-00478 - 873 Larch 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 TC Plumbing Tracy Clark City Sugar City State / Province / Region Idaho Postal / Zip Code 83448 Country United States Update new contact information that is not already on file with the City of Rexburg Street Address 5572 E. 3000 N. Address Line 2 pipewrench1970@gmail.com 208-709-7343 Plumbing PLB-C-12175 2/28/2021 10,000.00$ Permit Information Please enter in the following format: 00-00000 19-00478 Jessup 873 Larch Dr. Acceptance Sign 1/6/2020