HomeMy WebLinkAboutWORK ACCEPTANCE FORM UPSTREAM PLUMBING - 21-00636 - Vue Advisors - 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 acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Upstream Plumbing
Steve Billman
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
billmans1@gmail.com 208-681-4169
Plumbing PLB-C-12258 8/31/2024 12,000.00$
Permit Information
Please enter in the following format: 00-00000
21-00636 Vue Advisors - Remodel
859 S Yellowstone Hwy, 203
Acceptance
Sign 9/14/2021