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HomeMy WebLinkAboutWORK ACCEPTANCE FORM DAN'S PLUMBING & HEATING - 19-00577 - 107 & 119 N 1st E - Ollie Manor - New MFRContractor 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 Dan's Plumbing Tyler Teske City Ashton State / Province / Region ID Postal / Zip Code 83420 Country United States Update new contact information that is not already on file with the City of Rexburg Street Address 421 Main Street Address Line 2 PO Box 831 dansplumbing93@gmail.com 2086523281 2082000024 Plumbing 040493 4/30/2020 44,000.00$ Permit Information Please enter in the following format: 00-00000 19-00577 Ollie Manor 111 N 1st E, Rexburg, ID 83440 Acceptance Sign 5/13/2020