HomeMy WebLinkAboutWORK ACCEPTANCE FORM ARCHIBALD PLUMBING - 21-00665 - 128 N 4th W - Mobile Home to real propertyContractor 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
archibald plumbing
Brad Archibald
City
Rexburg
State / Province / Region
ID
Postal / Zip Code
83440
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
843 N 5th W
Address Line 2
archiplumb@hotmail.com 2083564460
Plumbing plb-c-11486 9/30/2024 780.00$
Permit Information
Please enter in the following format: 00-00000
21-00665 Mobile home to real property
124 N 4th W
Acceptance
Sign 11/23/2021