HomeMy WebLinkAboutWORK ACCEPTANCE FORM EAST IDAHO PLUMBING CO - 21-00923 - 290 Baldwin Dr - Basement FinishContractor 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
East Idaho Plumbing Co. LLC
Dennis Moon
City
Ashton
State / Province / Region
ID
Postal / Zip Code
83420
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
1564 Sadorus Hill Rd
Address Line 2
dmoon335@gmail.com 2084191965
Plumbing 039836 2/28/2022 2,600.00$
Permit Information
Please enter in the following format: 00-00000
21-00923 290 Baldwin Dr.- Basement finish
290 Baldwin Dr. Rexburg, ID 83440
Acceptance
Sign 12/22/2021