HomeMy WebLinkAboutWORK ACCEPTANCE FORM RIVER ROCK PLUMBING AND HEATING - 22-00078 - 341 W 1st N Units 1 & 2 - New DuplexContractor 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
River Rock Plumbing and Heating
Jeff Smith
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
138 N. 4100 E.
Address Line 2
jsperformancehorses@gmail.com 2083903295
Plumbing PLB-C-11360 11/11/2022 15,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00078 Mike Neff
339 W. 1st N.
Acceptance
Sign 5/3/2022