HomeMy WebLinkAboutWORK ACCEPTANCE FORM SUMMERS PLUMBING - 22-00211 - 887 Jet Stream Dr Suite 101 & 102 - Justin Packard GymContractor 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
Summers Plumbing
Casey Summers
City
Idaho Falls
State / Province / Region
ID
Postal / Zip Code
83401
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
844 Dennis Cir
Address Line 2
summersplbg@gmail.com 208-221-3837
Plumbing PLB-C-9243 6/30/2025 18,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00211 Justin Packard Shop
887 Jet Stream Dr
Acceptance
Sign 7/5/2022