HomeMy WebLinkAboutWORK ACEPTANCE FORM FIRST STREET PLUMBING AND HEATING - 22-00738 - 116 Birch Ave - MechanicalContractor 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
First Street Plumbing and Heating
Tom Gifford
City State / Province / Region
Postal / Zip Code Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
Address Line 2
firststreetplumbing@gmail.com 208-522-6896
Mechanical (HVAC)HVAC-C-587 4/30/2026 $
Permit Information
Please enter in the following format: 00-00000
22-00738 116 Birch Ave
116 Birch Ave
Acceptance
Sign 5/3/2023