HomeMy WebLinkAboutWORK ACCEPTANCE FORM EAST IDAHO PLUMBING CO - 21-00313 - 320 S 4th E - 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
East Idaho Plumbing Co. LLC
Dennis Moon
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
440 north 3rd west
Address Line 2
dmoon335@gmail.com 2084191965
Plumbing 039836 6/6/2022 20,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00313 Roger Clark
320 south 4th east rexburg idaho
Acceptance
Sign 6/8/2021