HomeMy WebLinkAboutWORK ACCEPTANCE FORM WOLVERINE PLUMBING - 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
Wolverine Plumbing
Aaron Taylor
City
Shelley
State / Province / Region
ID
Postal / Zip Code
83274
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
P.O. Box 451
Address Line 2
wolverineplumbing79@gmail.com 2086044576
Plumbing 023792 1/31/2025 12,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00078 Mike Nef duplex
341 west 1st north Rexburg
Acceptance
Sign 6/22/2022