HomeMy WebLinkAboutWORK ACCEPTANCE FORM ADDISON PLUMBING LLC - 19-00419 - Waste Water Treatment Plant - RestroomContractor 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
Addison Plumbing LLC
Jay Moore
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
4177 E 300 N
Address Line 2
myaddisonplumbing@gmail.com 503-515-8874
208-243-1748
Plumbing 030346 6/30/2021 $
Permit Information
Please enter in the following format: 00-00000
19-00419 Waste water
525 N 5th W
Acceptance
Sign 12/29/2020