HomeMy WebLinkAboutWORK ACCEPTANCE FORM TATES PLUMBING - 22-00319 - 1269 Stone Dr - Basement FinishContractor 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
Tates plumbing
Cody tate
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
tatesplumbing@gmail.com 208-521-8929
Plumbing 017991 6/30/2023 1,855.00$
Permit Information
Please enter in the following format: 00-00000
23-00319 1268
1268 Stone Dr.
Acceptance
Sign 6/21/2023