HomeMy WebLinkAboutWORK ACCEPTANCE FORM UPSTREAM PLUMBING - 21-00119 - Adams Elementary School - AdditionContractor 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
Upstream Plumbing, LLC
Steve Billman
City
Rigby
State / Province / Region
Idaho
Postal / Zip Code
83442
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
3689 E 100 N
Address Line 2
billmans1@gmail.com 208-681-4169
Plumbing plb-c-12258 8/31/2021 167,502.00$
Permit Information
Please enter in the following format: 00-00000
21-00119 Adams Elementary Addition
110 N 2nd E, Rexburg, ID 83440
Acceptance
Sign 4/27/2021