HomeMy WebLinkAboutWORK ACCEPTANCE FORM UPSTREAM PLUMBING - 22-00269 - Hibbard Elementary SchoolContractor 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
Upstream Plumbing
Steve Billman
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
billmans1@gmail.com 208-681-4169
Plumbing PLB-C-12258 8/31/2024 2,000.00$
Permit Information
Please enter in the following format: 00-00000
22-00269 Hibbard Elementary School
2335 N 3000 W
Acceptance
Sign 12/6/2023