HomeMy WebLinkAboutWORK ACCEPTANCE FORM REXBURG PLUMBING AND HEATING PLUMBING - 22-00263 - 7N Apartments - Bldg 4 - 4 PlexContractor 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 and Heating
Rexburg Plumbing
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
PO Box 759
Address Line 2
rexburgph@gmail.com 2083568770
Plumbing plb-c-13439 10/31/2022 40,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00263 4 plex
676 carlow
Acceptance
Sign 6/10/2022