HomeMy WebLinkAboutWORK ACCEPTANCE FORM - 23-00268 - Golden West Irrigation - Newton PlumbingContractor 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
Newton Plumbing
Jeremy Newton
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
newtonplumbing@hotmail.com 208-569-1126
Plumbing PLB-C-10656 8/31/2025 $
Permit Information
Please enter in the following format: 00-00000
23-00268 Golden West
2256 S Hwy 191
Acceptance
Sign 8/22/2023