HomeMy WebLinkAboutWORK ACCEPTANCE FORM WHITESIDES PLUMBING - 23-00054 - Maverik Store #505 - 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
Whitesides Plumbing
Christian Whitesides
City
Morgan
State / Province / Region
Utah
Postal / Zip Code
84050
Country
USA
Update new contact information that is not already on file with the City of Rexburg
Street Address
60 S. 300 W
Address Line 2
cswhitesides@gmail.com 801-301-9342
Plumbing PLB-C-12444 7/31/2025 19,000.00$
Permit Information
Please enter in the following format: 00-00000
23-00054 Maverik 505
859 W Main Street, Rexburg, ID.
Acceptance
Sign 3/7/2023