HomeMy WebLinkAboutWORK ACCEPTANCE FORM UPSTREAM PLUMBING - 22-00736 - Madison High School - Broadcase BoothContractor 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
Upstream plumbing
Steven Billman
City
Rigby
State / Province / Region
Idaho
Postal / Zip Code
83442
Country
Jefferson
Update new contact information that is not already on file with the City of Rexburg
Street Address
3689E 100N
Address Line 2
billmans1@gmail.com 208 681 4169
208 681 4169
Plumbing Plb-c-12258 8/31/2024 52,500.00$
Permit Information
Please enter in the following format: 00-00000
22-00736 Madison Baseball Broadcast Booth
Madison High School
Acceptance
Sign 10/12/2022