HomeMy WebLinkAboutWORK ACCEPTANCE FORM SUMMERS PLUMBING - 20-00146 - Idaho Central Storage - RemodelContractor 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
Summers Plumbing Inc.
Forrest Summers
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
summersplbg@hotmail.com 208-522-4082
Plumbing PLB-C-9243 6/30/2022 5,600.00$
Mechanical (HVAC)HVC-C-4192 6/30/2022 16,200.00$
Permit Information
Please enter in the following format: 00-00000
20-00146 Allen Shop
344 W 4th South
Acceptance
Sign 7/22/2020