HomeMy WebLinkAboutWORK ACCEPTANCE FORM KM PLUMBING - 23-00134 - 141 Charles Place - New SFRContractor 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
KM Plumbing
Tracy Berrett
City
Rigby
State / Province / Region
ID
Postal / Zip Code
83442
Country
Update new contact information that is not already on file with the City of Rexburg
Street Address
PO Boc 346
Address Line 2
kmplumbing2020@gmail.com 2083130098
Plumbing 044746 3/31/2023 27,850.00$
Permit Information
Please enter in the following format: 00-00000
23-00134 Gunderson
141 Charles Pl.
Acceptance
Sign 5/9/2023