HomeMy WebLinkAboutWORK ACCEPTANCE FORM REXBURG PLUMBING & HEATING - 21-00709 - Clair & Dees Point S Tires - 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
REXBURG PLUMBING & HEATING
NEPHI
City
REXBURG
State / Province / Region
IDAHO
Postal / Zip Code
83440
Country
MADISON
Update new contact information that is not already on file with the City of Rexburg
Street Address
766 NORTH YELLOWSTONE HWY
Address Line 2
RXPLGHTG@QWESTOFFICE.NET 208-356-8770
Mechanical (HVAC)PLB-C-13436 10/31/2022 $
Permit Information
Please enter in the following format: 00-00000
21-00709 ADVANCE-POINT S
103 NORTH 2ND EAST REXBURG,ID
Acceptance
Sign 1/3/2022