HomeMy WebLinkAboutWORK ACCEPTANCE FORM ARCHIBALD PLUMBING - 20-00878 - Crestwood Apartments - Water LineContractor 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
Archibald Plumbing
Brad Archibald
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
archiplumb@hotmail.com 208-356-4460
Plumbing PLB-C-11486 9/30/2021 600.00$
Permit Information
Please enter in the following format: 00-00000
20-00878 Crest Apartments
235 S 1st E
Acceptance
Sign 11/5/2020