HomeMy WebLinkAboutWORK ACCEPTANCE FORM IDAHO FURNACE PLUMBING SOURCE - 22-00270 - 35 W Main - 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
Idaho Furnace Plumbing Source
Ernie Cruz
City
Idaho Falls
State / Province / Region
Id
Postal / Zip Code
83401
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
1963 Walton Ave
Address Line 2
dispatch.ifps@gmail.com 208-521-0651
Plumbing 026656 6/30/2022 1,700.00$
Permit Information
Please enter in the following format: 00-00000
22-00270 Tony Nielsen
35 W Main St Rexburg, Id 83440
Acceptance
Sign 6/2/2022