HomeMy WebLinkAboutWORK ACCEPTANCE FORM REXBURG PLUMBING & HEATING - HVAC - 22-00474 - Transfer Station - New Scale HouseContractor 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 & Heating
KJ Johnson
City
Rexburg
State / Province / Region
Idaho
Postal / Zip Code
83440
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
P.O. Box 759
Address Line 2
rexburgph@gmail.com 208-390-3353
Mechanical (HVAC)039671 8/31/2022 21,806.00$
Permit Information
Please enter in the following format: 00-00000
22-00474 Madison Transfer Station
529 Airport
Acceptance
Sign 7/19/2022