HomeMy WebLinkAboutWORK ACCEPTANCE FORM CIRCLE C PLUMBING - 20-00557 - 1012 Cypress Loop - Price 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
Circle c plumbing
Paul or Nick
City
BLACKFOOT
State / Province / Region
ID
Postal / Zip Code
83221
Country
Bingham
Update new contact information that is not already on file with the City of Rexburg
Street Address
294 E 200 N
Address Line 2
circlecplumbing@gmail.com 2086815444
Plumbing 024593 5/31/2022 $
Permit Information
Please enter in the following format: 00-00000
20-00557 Gerald price
0
Acceptance
Sign 7/14/2020