HomeMy WebLinkAboutWORK ACCEPTANCE FORM MILLER PLUMBING - 20-00201 - 1259 Stone 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
Miller Plumbing
Jay Millet
City
SAINT ANTHONY
State / Province / Region
ID
Postal / Zip Code
83445-1628
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
PO Box 13
Address Line 2
arcticcatm7@yahoo.com 2083904063
Plumbing Plb-c-12162 6/3/2020 10,500.00$
Permit Information
Please enter in the following format: 00-00000
20-00201 Sky Meadows
1259 stone dr
Acceptance
Sign 6/3/2020