HomeMy WebLinkAboutWORK ACCEPTANCE FORM DIAMOND K PLUMBING AND HEATING - 23-00052 - 208 Physical Therapy - RemodelContractor 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
Diamond K Plumbing and Heating
Kyle Williams
City
Rexburg
State / Province / Region
Idaho
Postal / Zip Code
83440
Country
Madison
Update new contact information that is not already on file with the City of Rexburg
Street Address
5119 W 5000 N
Address Line 2
kwillia77@gmail.com 2083133388
2083133388
Plumbing PLB-C-11622 3/31/2025 1,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00052 Tyrel Nelson Office, Physical Therapy
1120 Stocks Ave, Rexburg Idaho
Acceptance
Sign 2/1/2023