HomeMy WebLinkAboutWORK ACCEPTANCE FORM DIAMOND K PLUMBING & HEATING - 20-00096 - 66 Valley View 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
Diamond K Plumbing and Heating
Kyle Williams
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
kwillia77@gmail.com 208-313-3388
Plumbing PLB-C-11622 3/31/2022 $
Permit Information
Please enter in the following format: 00-00000
20-00096 Andy Johnson - New SFR
66 Valley View Dr
Acceptance
Sign 11/6/2020