HomeMy WebLinkAboutWORK ACCEPTANCE FORM REXBURG PLUMBING AND HEATING - 23-00774 - YellowStone RV - BathhouseContractor 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
Rexburg Heating and Plumbing
Nephi Allen
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
rexburgph@gmail.com 208-356-8770
Mechanical (HVAC)039740 12/31/2026 8,500.00$
Plumbing PLB-J-11785 10/31/2024 28,673.00$
Permit Information
Please enter in the following format: 00-00000
23-00774 YellowStone RV - Bathhouse
2125 W 2000 S
Acceptance
Sign 5/8/2024